Act 11/9/56 P.B. Ac. 4412(1) BROMLEY ??? Cat BRO 51 BOROUGH OF BROMLEY Annual Report of the MEDICAL OFFICER OF HEALTH on the HEALTH OF THE BOROUGH OF BROMLEY 1955 INCLUDING ANNUAL REPORT ON THE SCHOOL HEALTH SERVICES H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. Medical Officer of Health. BOROUGH OF BROMLEY Annual Report of the MEDICAL OFFICER OF HEALTH on the HEALTH OF THE BOROUGH OF BROMLEY 1955 INCLUDING ANNUAL REPORT ON THE SCHOOL HEALTH SERVICES H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. Medical Officer of Health. 3 CONTENTS. Page Members of the Town Council 7 Staff 7 Prefatory Letter 9 Section A. Vital and Other Statistics and Social Conditions of the Area. Vital Statistics 14 Births 16 Deaths 16 Meteorological Observations 20 Morbidity Statistics 18 Open Air Recreational Amenities 20 Population 16 Medical Examinations 18 Unemployment 19 Section B. General Provision of Health Services for the Area. Ambulance Service 34 Disinfection 26 Domiciliary Midwifery 33 Domestic Help Service 34 Health Visiting 33 Home Nursing Service 34 Hospitals 33 Laboratory Service 25 Local Clinic Services 34 Medical Loan Depots 26 Moral Welfare 31 National Assistance Act, 1948 24 Nursing Homes 24 Old People—Welfare 27 Public Mortuary 24 Venereal Diseases 33 Women's Welfare Clinic 33 Section C. Sanitary and Environmental Circumstances of the Area. Cesspools 41 Diseases of Animals Acts 44 Drainage and Sewerage 41 Factories Acts, 1937 and 1948 38 Heating Appliances (Fireguards) Act, 1952 42 Pet Animals Act, 1951 43 Petroleum (Regulation) Acts, 1928 and 1936 45 Prevention of Damage by Pests Act, 1949 44 Public Cleansing, Refuse Collection and Disposal 42 Rag Flock and other Filling Materials Act, 1951 43 Registries for Female Domestic Servants 46 Retail Market 46 Rivers, Streams and Lakes 41 Sanitary Inspection of the Area 39 Shops Act, 1950 43 Smoke Abatement 42 Swimming Baths and Pools 41 Verminous Conditions and Uncleanliness 42 Water Supply 39 4 Page Sbction D. Housing. Housing Inspections and Abatements 48 Housing Repairs and Rents Act, 1954 48 Housing Statistics 48 Moveable Dwellings 50 Rehousing 49 Section E. Inspection and Supervision of Foods. Bacteriological Examinations 58 Food and Drugs Act, 1938—Food Sampling 52 Food and Drugs Act, 1938—Section 14 56 Food Premises 57 Game Act, 1831 60 Meat Inspection 59 Merchandise Marks Act, 1926 59 Milk and Dairies Regulations, 1949 58 Special Enquiries (Food and Drugs) 56 Unsound Food 57 Section F. Prevalence of, and Control Over, Infectious and Other Diseases. Acute Anterior Poliomyelitis 62 Chest Clinic 67 Diphtheria 63 Diphtheria Immunisation 63 Dysentery 63 Food Poisoning 63 Mass X-Ray 66 Measles 63 Pneumonia 64 Puerperal Pyrexia 68 Scarlet Fever 64 Smallpox 64 Smallpox—Vaccination 64 Tuberculosis 65 Tuberculosis Care Committee 67 Typhoid Fever 67 Whooping Cough 68 APPENDIX—STATISTICAL TABLES. Table I.—Summary of Statistics 71 „ II.—Causes of Death 72 „ III.—Infant Mortality 71 „ IV.—Analysis of Causes of Infant Deaths 74 „ V.—Notifiable Infectious Diseases—Ward Distribution, Attack and Mortality Rates 75 „ VI.—Notifiable Infectious Diseases—Seasonal Incidence 76 „ VII.—Summary of the work of the Sanitary Inspectors 77 „ VIII.—Nuisances, Defects and Contraventions Abated 80 5 Page SCHOOL HEALTH SERVICE, 1955. Members of the Committee for Education 84 Officers of the Committee 84 Staff 84 Introductory Letter 85 Audiometry 92 Dental Service 94 Ear, Nose and Throat Defects 96 Employment of Young Children 99 Handicapped Children 98 Independent Schools 93 Infectious Diseases in Schools 100 Minor Ailments 90 Ophthalmic and Orthoptic Clinics 95 Orthopaedic and Physiotherapy Clinics 96 Other Examinations 94 Periodic Medical Inspections 89 Physical Education 101 School Hygiene and New Schools 90 Schools—Further Education and Clinics 88 Special Examinations 92 Speech Clinic 97 STATISTICAL TABLES. Table I.—Medical Inspection of Pupils attending Maintained Primary and Secondary Schools 110 A. Periodic Medical Inspections 110 B. Other Inspections 110 C. Pupils found to require treatment 110 „ II.—A. Return of Defects found by Medical Inspection in the Year 1955 1ll B. Classification of the General Condition of Pupils Inspected during the Year, in age groups 111 „ III.—Group I. Diseases of the Skin 112 Group II. Eye Diseases, Defective Vision and Squint 112 Group III. Diseases and Defects of Ear, Nose and Throat 112 Group IV. Orthopaedic and Postural Defects 112 Group V. Minor Ailments 112 „ IV.—Dental Inspection, Treatment and Orthodontics 113 „ V.—Infestation with Vermin 114 „ VI.—Orthoptic Clinic 114 „ VII,—Handicapped Pupils 114 „ VIII.—Independent Schools 116 Child Guidance 117 Juvenile Delinquency 117 Boot Club 117 Provision of Clothing 117 7 MEMBERS OF THE TOWN COUNCIL (as at 31.12.55) *The Mayor (Alderman Samuel Lane. J.P.) Aldermen: S. G. W. Baylis *J. S. Marriott (Chairman of Public Health Committee) Councillors : *R. N. Allen F. G. Austin C. M. Baulf *F. W. Berringer *S. L. Best, J.P. G. W. Brown. M.B.E. *G. E. L. Chapman-Hatchett *J. C. Clayton *W._ K. Curtis *A. D. Daysh M. L. Dempster (Mrs.) H. F. Goodway J. L. Hunt C. E. Latter *F. G. V. Lovell *L. M. Prince (Mrs.) R. H. Roberts R. S. Shillingford A. A. J. Wells C. W. Wilmot L. C. Winterton. J.P. " * " denotes members of the Public Health Committee. STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health: H. B. C. CARTER-LOCKE, m.b., b.s., m.r.c.s., l.r.c.p., d.p.h. (also Medical Officer of Health to Orpington Urban District Council and Chislehurst and Sidcup Urban District Council.) (Appointed 13.1.55) Deputy Medical Officer of Health: A. J. I. KELYNACK, m.b., b.s., d.p.h. (also Deputy Medical Officer of Health to Orpington Urban District Council and Chislehurst and Sidcup Urban District Council.) (Appointed 21.2.55) Assistant Medical Officers : †P. A. CURRIE, m.r.c.s., l.r.c.p. tMrs. C. MAXWELL, m.a., m.b., b.ch., m.r.c.s., l.r.c.p., d.c.h. Chief Sanitary Inspector, Chief Food and Drugs Act Inspector, Inspector under the Petroleum Acts, Diseases of Animals Acts, Shops Act, Rag Flock and Other Filling Materials Act, Pet Animals Act, and Heating Appliances (Fireguards) Act: G. R. WOODS, m.s.i.a., a.r.s.h. (1, 2, 3, 4, 5). 8 District Sanitary Inspectors, Food and Drugs Act inspectors, and Inspector's under the Rag Flock and Other Filling Materials Act, Pet Animals Act, and Heating Appliances (Fireguards) Act: T. C. TOWERSEY, m.s.i.a. (1, 2, 3). D. K. EVANS, m.s.i.a. (1, 2, 3, 6). P. R. LIGHT, m.s.i.a., a.r.s.h. (1, 2, 6). P. DRINKWATER, m.s.i.a. (1, 2). Health Visitors and School Nurses: tMiss E. CHENERY (7, 8, 9) †Mrs. V. GREIG (7, 8, 9) †Miss E. HATCH (7, 8, 9) †Miss W. G. HEMMINGS (7, 8, 9) †Miss K. OWENS (7, 8, 9) †Mrs. N. M. TAYLOR (7, 8, 9) †Miss M. E. WOOTTON (8, 9, 10) CLERICAL STAFF : Chief Clerk : S. F. JUDD. E. P. J. WYTHE. Mrs. D. COX. Mrs. W. J. FOOT. Miss E. W. LEPPER (11) Miss M. N. CROXSON. Mrs. L. D. JOHNSON (Appointed 15.6.55) Mrs. R. BAKER. (Resigned 14.5.55) Mrs. R. C. TYE. "†" denotes officers employed by the Kent County Council. Other Appointments: Assistant Rodent Officers: J. L. GOUGH, A.R.S.H. N. W. HAMBLIN (Appointed 10.10.55) Outdoor Staff : Disinfector and Drain Tester: J. W. SEAGER. Rodent Operative : R. B. THOMPSON (resigned Oct., 1955) Market Superintendent : W. THRIFT (Part-time). The figures denote:— 1. Certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. 2. Royal Sanitary Institute Certificate for Meat and Other Foods. 3. Royal Sanitary Institute Smoke Certificate. 4. Certificate of Examination Board of the Sanitary Inspectors' Association. 5. Diploma of the Institute of Hygiene (London). 6. Royal Sanitary Institute Certificate for Sanitary Science as applied to Public Works and Buildings. 7. State Registered Nurse. 8. State Certified Midwife. 9. Health Visitors' Certificate of the Royal Sanitary Institute. 10. State Registered Children's Nurse. 11. Unestablished or Temporary Staff. 9 To the Mayor, Aldermen and Councillors of the Borough of Bromley. Mr. Mayor. Ladies and Gentlemen, In an age when the majority of people have a surfeit of rather indigestible reading matter they are compelled to study, it is perhaps expecting too much to imagine that my words will be ravenously devoured by a large section of the population, but something will have been attained if those who have read as far as this, have had their interest sufficiently aroused to pursue this letter to its close. A determined effort has been made this year to try and make the report more readable and this has involved a good deal of alteration in its composition, including a cover which it is hoped will be thought to be more eye catching and attractive than formerly. The theme of what follows will be the ever widening scope of the field of prevention. The main preoccupations of the Public Health department of the now fairly distant past, were such things as big epidemics of infectious disease and the eradication of the grosser forms of bad environmental hygiene. To-day we are still faced with many problems but the emphasis has shifted considerably. For example, we are all familiar with the expression " An Englishman's home is his castle " which is obviously meant to indicate amongst other things, that it is a place of safety and security for the family and yet. with all the publicity given to the toll of the roads, one feels that in too many instances, the most elementary precautions against home accidents are being neglected. Accidents in the home are, of course, not notifiable to the local authority but their toll in injury and even death in any one year in a town of this size is very considerable. The pangs of remorse suffered by those for instance who have caused injury to a child through failure to provide the simple measure of a proper fire guard, are a terrible thing but one cannot help wondering how often such carelessness is perpetuated until the fatal day suddenly and unexpectedly dawns. In addition, elderly persons are peculiarly susceptible to the dangers of fire, as they are to the risk of falls due to slippery floors, loose stair carpets and bad lighting. These are but a few of the hazards of the home, and the reader having had his or her attention drawn to this aspect of prevention, will be able to think of many more, and having thought will. I hope, take suitable evasive action before it is too late. Having referred to elderly people in the previous paragraph, it would seem that this is the appropriate time to touch on some of the many grievous problems that remain to be solved in this connection. As has been the case of recent years, the main difficulty 10 has been that of finding suitable accommodation for those who are no longer able to care for themselves at home and are unable to call upon the assistance of relatives or friends. Both statutory and voluntary bodies are doing their utmost to help and provide a wide range of services available for the use of the elderly, but here again. I feel that it is most important that, especially with an ageing population, the preventive aspect should not be lost sight of and that we should, one and all. live our lives to-day on the assumption that one day it may be our own turn to grow old. It may well be said that "this is all very fine, but what am I supposed to do about it," to which my short answer would be to keep your interests and hobbies throughout life however long it may be, so that when the time comes that the body is enfeebled, yet old age will be graceful and happy and as such, will still attract the younger generation, on whose help the old eventually become dependent. The next problem to which I should like to refer is that of the viruses. Virology as a science is still in its infancy, but it is already showing signs of developing into a very bonny childhood to be followed, one hopes, by an even greater future. It is not outside the realms of possibility that in the study of virology we may have the answers to many of the outstanding problems of medical science, and indeed, even as this is being written, preparations are well under way to start the vaccination scheme against anterior poliomyelitis, which is itself, of course, one of the virus diseases. The results of this great new attack on the ravages of a most distressing condition will be awaited eagerly, but it is bound to be some considerable time before its effect can be estimated accurately. I do not propose to refer further to the incidence of anterior poliomyelitis in this Borough during 1955, as those who are interested can find a full account under the infectious diseases section. As preventive measures have been given such prominence in this letter, I should be failing in my duty not to refer to the vexed question of smoking and cancer of the lung. That there is some association between the two seems to be fairly well established, but it is only right and proper to point out that this condition can effect non-smokers and therefore the inference is that smoking may be a contributory factor to cancer of the lung, rather than the actual cause of it. It is also interesting to note that the incidence of this disease is much higher in urban communities than in rural ones, which suggests that atmospheric pollution may be a contributory factor ; but of course, this does not take into account the many other differences existing between life in the town and life in the country, which may be of paramount importance. I have placed on record the bare facts as known to me and from which each, in the present state of our knowledge, must make his own decision. Those whose patience has not long ere this been exhausted and 11 who have read all the foregoing, will not be surprised to discover that my summarising is to the effect that there is an enormous field open for education in prevention, and that if this report makes any contribution in that direction, the time devoted to its compilation will certainly have not been wasted. The stage has now been reached when reference must be made to the vital statistics ; these show little change from the previous year except for an unexpected and disturbing rise in the infant mortality rate. I am unable to offer any reasoned explanation for the increase but feel that it must be just one of those unlucky years which, one hopes, will not recur. Having disposed of the vital statistics it is my very pleasant duty to refer to the arrival, early in the year of Dr. A. J. I. Kelynack as the new deputy Medical Officer of Health. We are indeed fortunate to obtain an officer of such ability and enthusiasm and I am personally indebted to him for his great contribution to the running of the department. This report cannot be concluded without reference to the great kindness and co-operation I have received in my first year as your Medical Officer of Health, from a very wide range of individuals and organisations. It is obviously impossible to thank everyone separately, but a few general observations would not be out of place. I acknowledge with grateful thanks, the help I have had from my colleagues in the Hospital and General Practitioner services— their willing assistance having lightened my burden enormously. I must also thank my own staff for their very material assistance throughout the year—the sanitary inspectors under the guidance of that ever faithful stalwart. Mr. Woods, under whose control Bromley Market has prospered to an extent quite beyond expectations, and the clerical staff who have worked so well under the able and efficient administration of Mr. Judd. Last but by no means least, I should like to express my gratitude to the Public Health Committee for their support and encouragement which do so much to make my task lighter and more worthwhile. I am, Your obedient Servant. H. B. C. CARTER-LOCKE. Medical Officer of Health. May, 1956. SECTION A. VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. 14 SECTION A. VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 6,519 Registrar General's estimate of total population (mid-year) 1955 64,780 Rateable Value at 31st March, 1955 £800,501 Rateable Value at 1st April, 1956 £1,292,752 Estimated product of a Penny Rate as at 1st April, 1956 £5,375 Number of Valuation assessments as at 31st March, 1955:— (a) Houses and Flats:— Not exceeding £10 Rateable Value 348 £11 to £13 Rateable Value 552 £14 to £20 Rateable Value 4,991 £21 to £30 Rateable Value 7,298 £31 to £40 Rateable Value 2,737 £41 to £50 Rateable Value 1,509 £51 to £75 Rateable Value 1,337 £76 to £100 Rateable Value 412 Exceeding £100 Rateable Value 327 19,511 (b) Commercial 1,417 (c) Licensed Premises 40 (d) Entertainment and Recreational 89 (e) Public Utility 20 (f) Educational and Cultural 29 (g) Industrial 55 (h) Miscellaneous 272 Total 21,433 Mileage of Roads as at 31st March, 1955:— County Roads, Class 1 12.26 County Roads, Class 2 6.48 County Roads, Class 3 5.16 District Roads 64.61 Unadopted Roads 15.98 Total 104.49 Vital Statistics. Live Births. Total. Male. Female. Legitimate 784 393 391 Birth Rate 12.7 (crude) per 1,000 total population. (Adjusted rate for comparison with other areas 12.9.) Illegitimate 39 18 21 823 411 412 The area comparability factor supplied by the Registrar General for the purpose of determining rates for comparison with other parts of the country is 1.02. 15 Stillbirths. Total. Male. Female. Legitimate 10 4 6 Stillbirth Rate 0.17 per 1,000 total population and 13.2 per 1,000 (live and still births). Illegitimate 1 1 — 11 5 6 Deaths. Total. Male. Female. 741 336 405 Death Rate 11.4 per 1,000 total population. (Adjusted rate for comparison with other areas 9.9.) The area comparability factor calculated by the Registrar General for comparison of death rates, is 0.87. Deaths from Puerperal Causes. Puerperal Sepsis Nil Maternal Mortality Rate Nil per 1,000 (live and still births). Other Puerperal Causes Nil Deaths of Infants under 1 year of age. Total. Male. Female. Legitimate 25 11 14 Infant Mortality Rate 31.6 per 1,000 live births. Illegitimate 1 1 — 26 12 14 All Infants per 1,000 live births 31.6 Legitimate Infants per 1,000 live legitimate births 31.9 Illegitimate Infants per 1,000 live illegitimate births 25.6 Vital Statistics of the Borough for the past ten years. Year Population No. of Births (Live) No. of Deaths No. of Infant Deaths No. of Maternal Deaths Birth Rate Death Rate Infant Mortality Rate Maternal Mortality Rate 1946 60,540 1,176 656 31 1 19.4 10.8 26.3 0.82 1947 62,640 1,308 731 25 1 20.9 11.7 19.11 0 74 1948 63,360 1,042 631 21 1 16.4 9.9 20.15 0.94 1949 64,140 1,030 699 16 1 16.1 10.9 15.5 0.95 1950 64,610 892 739 19 Nil 13.8 11.4 21.3 Nil 1951 64,550 916 735 11 Nil 14.2 11.4 12.0 Nil 1952 64,350 908 720 20 Nil 14.1 11.2 22.0 Nil 1953 64,590 880 692 13 Nil 13.6 10.7 14.8 Nil 1954 64,800 824 727 17 Nil 12.7 11.2 20.6 Nil 1955 64,780 823 741 26 Nil 12.7 11.4 31.6 Nil Statistics for England and Wales, 1955. Birth Rate (per 1,000 total population) 15.0 Death Rate (per 1,000 total population) 11.7 Infant Mortality Rate (per 1,000 live births) 24.9 (lowest ever recorded in the country.) 16 POPULATION The Registrar General's estimate of the total population of the Borough, mid-year, 1955, was 64.780, which is a decrease of 20 over the figure for the previous year. This figure gives a density of 9.9 persons to the acre. The natural increase of population, measured by excess of births over deaths, was 82. It would appear that the population has now reached a steady level and it cannot be anticipated that any great changes in numbers are likely in the immediately ensuing years. BIRTHS The birth rate for the year is 12.7 per 1,000 total population. There were 823 live births registered, as against 824 during 1954. Of this number. 411 were males and 412 females. The adjusted rate, for comparison with other areas, is 12.9. The similarity with the previous year is the outstanding feature in this instance. The birth rate for England and Wales as a whole is 15.0 so we are well below the national average. Having considered the over all birth rate. I must now draw your attention to the illegitimate birth rate, which was 47.96 per 1,000 live and still births. There were 40 illegitimate births registered, of which 19 were males and 21 females. Finally, reference must be made to the stillbirths, of which eleven were registered, giving a rate of 0.17 per 1.000 total population, and 13.2 per 1,000 live and still births. Five of the stillbirths were males and six females. DEATHS There were 741 deaths appertaining to the Borough and registered during 1955, giving a Death Rate of 11.4 per 1.000 total population. The adjusted rate for comparison purposes is 9.9. The rate for England and Wales is 11.7. Of the Bromley deaths registered, 336 were males and 405 females. An analysis of the ages at death shows that of those registered:— Male. Female. 26 were under 1 year of age 12 14 3 were 1 and under 5 years of age 2 1 6 were 5 and under 15 years of age 3 3 2 were 15 and under 25 years of age 2 — 29 were 25 and under 45 years of age 20 9 142 were 45 and under 65 years of age 78 64 164 were 65 and under 75 years of age 84 80 369 were 75 years of age and over 135 234 336 405 17 By comparison with the death rate of 1954, there is a small increase of 0.2, which is negligible, particularly as the increase includes the rise in infant mortality to which reference has already been made. Full details of the causes of death will be found in Table II in the Appendix. The following table of comparative rates per 1,000 population for the last six years of certain causes of death in the Borough, may be of interest:— 1950 1951 1952 1953 1954 1955 Cancer (all sites) 1.9 1.98 1.77 2.38 1.99 1.83 Congenital Causes 0.12 0.09 0.16 0.11 0.08 0.11 Heart Disease 6.31 5.56 6.31 5.34 5.88 5.94 Infectious Diseases 0.015 0.062 0.031 0.03 0.03 0.03 Influenza 0.03 0.11 0.00 0.11 0.01 0.00 Respiratory Diseases (non-T.B.) 0.68 1.27 1.17 0.91 1.09 1.49 Tuberculosis 0.26 0.31 0.17 0.14 0.12 0.08 The most encouraging feature of these figures is the continued fall in the death rate from tuberculosis, but the number of deaths attributable to this disease cannot be expected to fall much further until the disease has been eliminated from the community entirely. There is, unfortunately, a reverse tendency in the case of nontuberculous respiratory diseases, but this is probably only to be expected with an ageing population. There were eighteen deaths from violence, including four motor vehicle accidents, seven other accidents, and seven suicides, and although an unnecessary loss of eighteen lives is a tragedy, at least one can say that this number is one less than during the previous year. Cancer of the Lung, to which reference has previously been made in this report, accounted for 25 deaths, which was three less than in 1954. With such comparatively small numbers this change is of no significance statistically, but it is preferable to having to record an increase. It is pleasing to report that for the sixth year in succession there were no maternal deaths in the Borough, but, unfortunately, the infant death rate has risen from 20.6 in 1954, to 31.6 during the year under review. This compares unfavourably with the national figure which is 24.9. This large percentage increase over the year represents nine additional deaths and. as I have already said, is probably just an unfortunate incident which one trusts will not be repeated. 18 MORBIDITY STATISTICS A weekly return is received from the Regional Office of the Ministry of National Insurance giving details of the number of certificates for sickness benefit received at the Local Office. These figures give some indication of the seasonal trend of illness in the area, and it will be seen that the year 1955 followed the expected trend, i.e., that the highest incidence of illness occurred during January and February and then declined to its lowest level in August, and then gradually rose again towards the end of the year. Four weeks ending First. Number of certificates of incapacity. Intermediate. Final. 25th January 1,529 4,641 985 22nd February 1,575 4,876 1,292 22nd March 1,397 4,680 1,163 19th April 1,044 4,474 1,006 17th May 831 4,260 698 14th June 658 4,139 631 12th July 663 3,924 607 9th August 563 3,739 543 6th September 561 3,614 449 4th October 602 3,718 502 1st November 962 3,887 692 29th November 1,014 3,967 810 27th December 785 3,806 670 MEDICAL EXAMINATIONS During the year, 40 members, or potential members, of the staff were medically examined for superannuation purposes, etc. This number is a great increase compared with previous years, the reason being that early in the year, the policy was changed by which it had formerly, in the main, been the responsibility of the prospective employee to arrange for his or her own medical examination. The present arrangement is that all medical examinations are undertaken by this department. 19 UNEMPLOYMENT I am indebted to the Manager of the Bromley Employment Exchange for the following information with regard to unemployment in the area during 1955:— "The following figures illustrate the amount of unemployment in the Borough during 1955 as compared with 1954. 1955 Men. Women. Total. 1954 Men. Women. Total. 10th Jan. 75 46 121 11th Jan. 159 70 229 14th Mar. 59 47 106 15th Mar. 116 66 182 16th May 40 40 80 10th May 66 76 142 11th July 39 30 69 12th July 66 58 124 12th Sep. 44 36 80 13th Sep. 67 57 124 14th Nov. 40 47 87 15 th Nov. 78 57 135 12th Dec. 50 47 97 6th Dec. 71 44 115 The figures indicate that throughout the year unemployment has steadily declined compared with the corresponding months in the previous year. From May onwards unemployment has been at its lowest level since 1945. In April, as result of a Trade dispute by maintenance men in the London National Newspaper industry, 148 men affected by the dispute registered as unemployed for 4 or 5 days only. Employment in the area has continued at a high level throughout the year and demands for workers have been continuous. During last winter and to date during this winter, there has been less unemployment in the building industry and the problem of seasonal unemployment among Painters has been less acute. Unemployment among men is mainly confined to the older blackcoated worker or to those affected by some degree of disability. Of the 40 registered as unemployed on 14th November. 25 were age 55 and over. 12 were between 40 and 54 and only 3 were under 40. Among women, unemployment is in the main, confined to clerical and shop workers in the higher age groups and to women who require work for restricted hours owing to domestic responsibilities. It will be seen from the preceding paragraph that what little unemployment exists in the Borough is mainly confined to the older worker. In this connection the National Advisory Committee on the Employment of Older Men and Women issued a second report on 6th December in which they say they are encouraged by the progress already achieved in promoting the employment of older people, but are convinced that there is room for much wider adoption of the recommendations made in their first report and for further experiment and research to overcome the difficulties which remain, 20 In March, 1954, the Ministry of Labour and National Service opened an Industrial Rehabilitation Unit at Waddon near Croydon. The object of this Unit is to provide men and women, who have had a long spell of inactivity following illness, injury or any other cause, the means of restoring them, under expert direction, to their full working capacity and giving them professional guidance, where there is need, about the kind of work likely to be most suitable. The Unit is to a considerable extent dependent upon the medical profession and hospital staffs in recommending suitable cases for this course of industrial rehabilitation and in August of this year every medical practitioner in the Borough was reminded of the facilities available at this Unit. During 1955, 8 men and 5 women from the Borough have undertaken the course. Of the men 4 have been satisfactorily placed in employment, one of these received vocational training in a commercial course. The remaining 4 men are still at the Unit. Three of the women have been satisfactorily placed and the other 2 are undergoing vocational training in a commercial course and shorthand-typing." METEOROLOGICAL OBSERVATIONS. The Borough Engineer has kindly furnished the following information from the records at the Climatological Station, Church House Gardens:— Total rainfall: 22.03 inches. Mean maximum daily temperature: 57.25°. Mean minimum daily temperature: 42.17°. Highest maximum temperature (on 22nd August): 86°. Lowest minimum temperature recorded (12th January): 19°. Lowest grass temperature recorded (20/1, 28/2, 31/3, 19/12): 19°. OPEN AIR RECREATIONAL AMENITIES. The value of Bromley's open spaces cannot be over estimated, for they provide rest and relaxation for the older members of the population and facilities for recreational activities for the younger generation, thus making a notable contribution to the general well being of the community. 21 Commons, Public Recreation Grounds and Gardens. Six hundred and three acres of land have been secured or reserved for public recreational purposes, representing 9.2 per cent. of the total acreage of the Borough. Acres. Roods. Poles. Bromley Public Golf Course 56 1 8 Church House Gardens 12 3 20 Elmstead Woods 61 1 36 Golf Course Playing Fields 41 1 5 Hayes Common (including Pickhurst Green) 213 1 32 Hollydale Open Space 6 1 0 Husseywell Open Space 2 1 30 Keston Common 55 1 24 Kings Meadow Recreation Ground 9 1 0 Library Garden 1 2 0 Martins Hill Recreation Ground 12 0 29 Oakley Road Recreation Ground 2 0 0 Pickhurst Green Recreation Ground 12 2 14 Queens Garden 2 1 4 Queens Mead Recreation Ground 10 3 15 Southborough Open Space 6 0 0 The Knoll Open Space 4 1 39 Turpington Open Space 1 3 10 Whitehall Recreation Ground 17 1 6 Widmore Open Space 3 1 28 Reserved: Hayes (Old) Rectory Grounds 2 0 25 Hillcrest Open Space 0 2 0 New Street Hill Open Space 11 2 8 Norman Park 56 0 0 603 1 13 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 24 PUBLIC MORTUARY. Eighteen bodies were taken to the public mortuary during the year, all of which were received from hospitals. Inquests were held in six cases. The comparatively little use that is made of the mortuary is probably due to the lack of facilities for refrigeration. NATIONAL ASSISTANCE ACT, 1948. Section 47 Under this section of the Act (as amended by the National Assistance (Amendment) Act, 1951) powers are given to the local authority for the compulsory removal of persons suffering from SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. NURSING HOMES. (Public Health Act, 1936. Sections 187/194.) There are six Nursing Homes on the register at the present time, with provision for a total of 98 beds for medical and surgical cases. There are no maternity beds provided in these Homes. The majority of the beds are occupied by aged sick or aged infirm patients and the Nursing Homes are fulfilling a very useful purpose in that they are providing accommodation for a type of case which in many instances it is extremely difficult to get into hospital. The Homes were inspected by the Deputy Medical Officer of Health at frequent intervals during the year and at no time were any contraventions found which called for action on the part of the Local Authority. Details of the Homes registered are:— Address No. of Beds Number of new patients received during 1955 Surgical Medical and Chronic 18, Blyth Road 25 — 73 42, Cambridge Road 8 — 8 17, Edward Road 12 — 31 24, Elmfield Road 10 — 2 47, Park Avenue 22 — 55 "St. Cecilia's" Sundridge Avenue 21 — 38 25 grave chronic disease, or who are aged, infirm or physically handicapped and who are living in insanitary conditions and unable to devote to themselves and not receiving from other persons proper care and attention. Although several cases were visited and investigated during the year it was not necessary to apply to the court for an order for compulsory removal. Section 50 This section of the Act places a duty on the local authority to arrange for the burial or cremation of the body of any person who has died or been found dead in their area if it appears that no suitable arrangements for the disposal of the body have or are being made. Expenses incurred by the local authority may be recovered from the estate of the deceased person or from any person liable to maintain the deceased person immediately prior to his death. During the year the Council arranged for the burial of one person under this section of the Act. LABORATORY SERVICE. Food and Drugs samples are sent to the Public Health Laboratory at Maidstone. This service ceased to be the responsibility of the County Council towards the end of 1955. and was taken over by the Public Health Laboratory Service (Directed by the Medical Research Council for the Ministry of Health). Swabs and other routine medical specimens are sent to the laboratory at Bromley Hospital, and I should like to take this opportunity of thanking Dr. Keall and his staff for the valuable assistance they have rendered. Details of swabs, specimens, etc., sent to these laboratories are given below:— Swabs (for Haemolytic Streptococci) 120 Swabs (for Diphtheria) 1 Faeces 35 Food Samples, etc. 497 Rag Flock Samples 15 Water Samples 66 Miscellaneous 19 753 26 DISINFECTION. Details of the work carried out during 1955 at the disinfecting station, Waldo Road Depot, are as follow:— Disinfections: Premises visited 120 Rooms disinfected 100 Articles disinfected 565 Disinfestations: Premises visited 14 Rooms disinfested 32 Articles disinfested 18 Articles Treated. Articles Destroyed. Beds 3 1 Mattresses 84 8 Bolsters 8 — Pillows 160 — Cushions 9 4 Blankets 127 — Sheets 39 — Eiderdowns 18 — Bedspreads 12 — Carpets — — Garments 108 — Miscellaneous 15 — 583 13 In the case of disinfections, rooms and furniture are sprayed with Formalin and Formalin candles are also burned. Articles are steam treated with a pressure of 5 lbs. per square inch. In the case of disinfestation of premises, rooms and furniture are sprayed with Zaldecide solution. Bedding and other articles are steam treated. BRITISH RED CROSS SOCIETYMEDICAL LOAN SERVICE. A medical loan service is provided by the British Red Cross Society at 34a. Market Square, Bromley. A full range of nursing requisites is kept at this depot. A small charge is normally made for the article hired, but in cases of distress and for most Old Age Pensioners, no charge is made. The depot is open on Monday. Tuesday. Thursday and Friday each week, between the hours of 10.30 - 12.30 and 2.30 - 4.0 p.m. 27 WELFARE OF OLD PEOPLE. Reports received on the various homes run by voluntary associations and public authorities are as follow:— "The Vane " and " Town Court," Bickley. These homes are run by the Welfare Department of the London County Council and the following details have been furnished by the Chief Officer of that Department:— "Town Court" "The Vane" Total number of beds 32 29 Residents on 31st December, 1954 30 29 Admissions during 1955 23 11 Discharges during 1955 22 18 Residents on 31st December, 1955 31 22 A new house. "Boscobel," Denbridge Road, Bickley, which is adjacent to "The Vane," will be opened shortly and will accommodate 23 residents. " Merevale," Bickley Park Road, Bickley. The North West Kent Housing Society. Limited (Homes for the Aged), run this home and the Secretary has kindly furnished the following information:— There is nothing new to report for the year 1955. The Home has fulfilled its task and provided accommodation for thirty-six old people, including one married couple and ten other men throughout the year. It is of interest to note that six of the residents are now over ninety; one attains her century in April next year. "Greenhill," Oaklands Road, Bromley. This report has been furnished by the General Secretary. Brook Lane Medical Mission:— The number of beds available in the home is twenty-two. During 1955, we have lost two residents by death, and one who became more infirm, was moved to another home. Three old ladies, living alone and in need of some care and attention, have been admitted during the year. Miss Flora Miller, one of the residents who has been with us for a long time, reached the age of one hundred years in September, and spent a very happy birthday in the home with relations and friends. She was thrilled to receive a message from Her Majesty the Queen, also from the Rt. Hon. Sir Winston Churchill. In October, the residents went to Brighton for two weeks, to a home there, while the Greenhill kitchen was made larger, and other improvements made. The balcony is being re-built and enlarged, 28 so that when the better weather comes, more of the old folk will be able to sit out in the sunshine. There are quite a number who cannot go farther than the balcony. We are hoping to go ahead, in 1956, with the building of an annexe to the home, as we need more ground floor accommodation. "Southwood Residental Club," Bickley. This year, W.V.S. have adopted a new policy for their residential clubs for elderly people, and it is now planned to look after the old people when they become feeble up to the point when they are actually in need of medical care and skilled nursing. In the past, when the residents have needed more care and attention, they have been transferred to Sharnbrook, the W.V.S. Half-way House, but now this extra care is to be given at Southwood as in the other residential clubs, and so the Committee have spent some time in making preparations for this extra care, and setting aside extra care rooms. By making one of our very large rooms into a 4-bedded room, and by using a little used staff sitting room, we have been able to set aside two rooms as extra care rooms. Plans are going ahead to decorate these rooms in bright and cheerful colours, as it is felt that this will be helpful to the happiness and recuperation of the old people who will be occupying the beds. The health of the residents over the year has been good, and our changes have been few. Although two women left us, one to go to relatives and the other to a nursing home, we did not take in any more women residents, owing to re-organisation of the rooms. Two men residents died, and we took in a further three. The residents still continue to do handicrafts each week, and enjoy working for the next exhibition. They have also made toys again for the Children's Wards at Farnborough Hospital, for Christmas. "Armstrong House," 1, Southlands Grove, Bickley. This Home is run by the S.O.S. Society, and I am indebted to the General Secretary for the following report:— Accommodation. Capacity 28 Weekly average 27.5 Admitted during the year 6 Present residents: Women 11 Men 17 Average age 82 years. 29 Only six vacancies arose during the year, as compared with nine in 1954. The increasing frailty of many of the residents is very noticeable. Medical attention remains on a very satisfactory basis, although admission to hospital has been very difficult to obtain except in cases of emergency. Somewhat contrary to expectations, the installation of a television set in the Home has been greatly appreciated by the residents. The usual coach outing, kindly arranged by the Ladies' Circle of Bromley, took place during the year and, as always, was much enjoyed. Local residents are most kind in inviting old people from the Home to tea. The Home continues to have the kind offices of the Rev. R. P. Appleton who also serves as a member of the House Committee. The staff position remains as in the 1954 report. It must, however, be noted that it is becoming increasingly difficult to find suitable women for the post of Assistant Matron. During the financial year ended 24th September, 1955, the total cost of maintaining the Home amounted to £4,399 against a total income of £4.967. leaving a surplus of income over expenditure of £568. This unusually satisfactory state of affairs is due almost entirely to the increased contribution towards maintenance from the Kent County Council. "Dunoran Home," Park Farm Road, Bickley. This Home is run by the Bermondsey and Southwark Group Hospital Management Committee, and I am indebted to the Medical Superintendent for the following information:— During 1955, fifty-five patients were admitted, thirty-nine discharged, and eighteen died. Many of the permanent younger patients were again able to go for a seaside holiday through the kindness of the Group Management Committee. Their places were occupied by patients from their homes, whose relatives needed a rest. The car which has been bought by some of the W.V.S. and their friends was a great boon, and there were many trips for shopping and sight seeing, which made a welcome break in the patient's routine. The patients now have their own entertainments committee and would welcome any offers from Bromley residents to lecture or entertain. 30 " Homefield " and "Elmwood," Southborough Road, Bickley. These Homes are run by the Bermondsey Medical Mission, and the Warden has kindly furnished the following report:— The past year has been marked by few changes. A new Sanitary Annexe was added to the ground floor at " Homefield." Several outings were arranged during the summer and also one to London during Christmas week. The health of the patients has been reasonably good and the fine summer made it possible for greater use to be made of the gardens. Regular services continue to be held each Sunday and are very much appreciated as few of the patients are able to attend Church. WOMEN'S VOLUNTARY SERVICES Over 60's Clubs. These Clubs meet once a week and old people have the opportunity of meeting others, making friends, playing games, doing handicrafts, reading, etc.. and having a cup of tea together. Sick visitors take tea to those unable to attend. The Members have been working for a Handicraft Exhibition to be held in April. 1956. Club leaders arrange outings to the sea in the summer, and half-day outings to the country in the spring and autumn. A Men's Inter-Club Darts League gives the members an opportunity of visiting the various clubs. Several of the clubs have their own concert party and entertain the other clubs in Bromley. A Darts Shield has now been given for the Ladies. Meals on Wheels and Luncheon Club. An average of 70 to 80 meals are cooked by voluntary workers and about 60 of these are taken out in insulated containers, in two W.V.S. vans. A luncheon club is run at the Meals Kitchen at St. Mary s Church House, College Road. Bromley, for mobile old people. These two services operate on Tuesdays, Wednesdays, Thursdays and Fridays. Over 14,500 meals were cooked last year, and the service fills a very great need, especially so in the winter months. 31 Welfare Work and Trolley Shops. W.V.S. members visit the two London County Council Homes, and "Dunoran." "Homefield" "St. Cecilia's." Lennard Hospital and Hayes Grove Nursing Home, and a trolley shop service is given where needed. Wheel chairs are loaned to those in need. W.V.S. members now have a converted van fitted with a winch, known as the " Bickley Bus." which enables them to take chronic sick in wheel chairs shopping and to visit the Over 60 Clubs. This has been a great joy to those who have been housebound for so long. MORAL WELFARE. Church Army Home, Wells Road, Bickley. The Sister-in-charge has kindly furnished the following report:— "There were thirteen mothers with their babies in the House at the beginning of the year. Eighteen mothers have since been admitted, making thirty-one in the House during the year. Of these, five mothers have returned to their relatives with the children ; the other members of the families having accepted the situation and taken the children into the families. One girl we were unable to keep and she went into Part III accommodation and the child was taken into care. One mother was incapable of ever caring properly for her child, and the child was accepted by Dr. Barnardos ; the mother going into lodgings. One girl has a resident job with her child. This is proving very satisfactory. Three girls went into lodgings. Two girls have married the putative father and three have married other men, who have been prepared to accept the children. Fifteen mothers with their babies are still resident in the Home. Unfortunately, for a long period during the summer the House was in quarantine for measles. Other than this the household has kept extremely fit. Denbridge House does meet a very real need for the mother who. anxious to keep her child and unable to return to her family or friends with the child, is seeking for a place where she can live, keeping the child with her and earning her own living, and the fee charged is reasonably within her income. 32 We are most grateful to the doctors for the regular weekly visits they make and for the interest and consideration they have given to all who are in our care. We are also most grateful to the Health Visitor for the help and advice she has always so readily given and for the personal interest which she takes in the mothers and babies who are in our care." Rochester Diocesan Association for Moral Welfare Home, Blyth Road. The following report has been furnished by the Superintendent:— "During the year 110 girls, women and children were admitted to the Home. Forty-four of the girls were maternity cases, and of this number, 27 were admitted to Farnborough Hospital, 7 to Bromley Hospital, 1 to Bcckenham Hospital, 1 returned home before the baby was born, 2 were transferred to other Homes and the remainder were still in the Home at the end of the year. Thirty-five were Kent cases, 1 from Sussex, and 8 were self paid. Shelter Cases.—During the year 26 cases were admitted for varying periods of time. At the end of the year the number in the Home was:— Six mothers and 6 babies, 2 shelter cases and 3 ante-natal cases. Total—11 girls and 6 babies." Report of Sister Papps, Outdoor Worker:— "Two hundred and three cases have been referred and dealt with and there were 47 cases in hand at the end of the year. Of the new cases. 80 were maternity, 81 were preventive cases concerning young people. 19 were matrimonial, 2 were rescue cases, and 21 miscellaneous. Of the maternity cases, 65 were single girls, 9 were married women having illegitimate children, 5 were divorcees and 1 was a widow. Ninety-one of the above cases were from Bromley and district. During the year 601 home visits have been paid, 1,437 interviews given and 28 meetings addressed." 33 HOSPITAL SERVICES. The following hospitals are within the area, and under the control of the Bromley Group Hospital Management Committee, whose offices are at Farnborough Hospital. Farnborough. Kent. (a) Bromley Hospital, Cromwell Avenue. General hospital with 133 beds. Bromley Hospital Maternity Units: 20. Masons Hill. Bromley. Provision for 34 beds. 118. Widmore Road. Bromley. Provision for 20 beds. Chest Clinic. Situate at the rear of the main Bromley Hospital buildings, with entrance from Tiger Lane. (b) Lennard Hospitals, Lennard Road. Provision for 56 beds for use by infectious disease cases. This number can be doubled in an emergency. Twenty-four beds are also provided at these hospitals for geriatric cases. Venereal Diseases. There is no clinic in the area which deals with these diseases. Patients are referred to the various hospitals with such clinics. COUNTY COUNCIL SERVICES. Health Visiting. Seven Health Visitors are employed in the area, and their time is equally divided between Health Visiting and work in connection with the School Health Services. In addition to their school work, they are responsible for Maternity and Child Welfare Centres. Immunisation and Vaccination Clinics, Home Visiting, After Care, and give advice on the care of young children, and advice to expectant and nursing mothers. Domiciliary Midwifery. Four full-time domiciliary midwives are employed in the area. Patients may obtain the services of a midwife on direct application or through the patient's private doctor. Women's Welfare Clinic. All Bromley patients are referred to the Chislehurst clinic. 34 Ambulance Service. The main depot for this area is at 12. Hayes Lane. Bromley. At the present time there are 29 ambulances and 20 sitting case cars based at this depot, the majority of which are radio controlled. Domestic Help Service. Applications for this service should be made to the District Organiser. Municipal Offices, Bromley. During the year 1955 this service continued to be in great demand, especially for old people and cases of illness in the home. The following cases received assistance during the year:— Maternity (expectant mothers) 94 Tuberculosis 9 Aged 360 Others 225 Total 688 Home Nursing Service. At the present time a day service only is given, and is obtainable on medical certification. There are 9 nurses (8 female and 1 male) working in the area. LOCAL CLINIC SERVICES. Ante-Natal Clinics. North Clinic, Station Road Thursday p.m. South Clinic, Princes Plain Monday p.m. Hayes School Clinic, George Lane Wednesday p.m. Child Welfare Centres. North Clinic, Station Road Wednesday p.m. South Clinic, Princes Plain Tuesday p.m. William Morris Hall, Masons Hill. Monday & Thursday p.m. First Aid Post, Southlands Road Wednesday & Friday p.m. Village Hall. Hayes Tuesday p.m. Village Hall, Keston First and third Thurs. in every month p.m. St. Andrew's Hall, Burnt Ash Lane Wednesday p.m. Minor Ailment Clinics (Schools). North Clinic, Station Road Monday to Friday a.m. South Clinic, Princes Plain Monday to Friday a.m. Medical Room, Hayes School, George Lane Monday to Friday a.m. Medical Room, Burnt Ash School Monday to Thursday a.m. Medical Room, Southborough School Mon., Wed. & Fri a.m. Medical Room, Aylesbury Rd. School Mon., Wed. & Fri a.m. 35 Dental Clinics. North Clinic, Station Road Monday to Friday a.m. & p.m South Clinic, Princes Plain Saturday a.m. (by appointment.) Specialist Clinics. North Clinic, Station Road South Clinic, Princes Plain Ophthalmic (Appointments only)— Monday & Wednesday a.m. Friday p.m. Orthopedic (Appointments only)— First & third Friday in every month p.m. Orthoptic (Appointments only)— Monday p.m. Tuesday a.m. & p.m. Thursday a.m. & p.m. Friday a.m. Physiotherapy (Appointments only)— Tuesday a.m. & p.m. Thursday a.m. Friday a.m. Speech (Appointments only)— Friday p.m. Lip Reading (Appointments only)- Wednesday 5-6 p.m. Saturday 10 a.m. - 12 noon Immunisation and Vaccination. North Clinic, Station Road Thursday 11 a.m. South Clinic, Princes Plain Wednesday 11 a.m. Medical Room, Hayes School Wednesday 11 a.m. (Immunisation only) Medical Room, Burnt Ash School Thursday 11 a.m. (Vaccination only) St. Andrew's Hall, Burnt Ash Lane Wednesday 3 p.m. SECTION C SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA. 38 SECTION C SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA. FACTORIES ACTS, 1937 AND 1948. The following is a copy of the return supplied to the Ministry of Labour and National Service, in respect of the year 1955:— I. Inspections for purposes of provisions as to health. Premises Number on Register Number of Occupiers Prosecuted Inspections Written Notices (a) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by the Local Authorities 58 39 4 — (b) Factories not included in (a) in which Section 7 is enforced by the Local Authority 231 149 8 — (c) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises *138 61 2 — Total 427 249 14 — II. Cases in which Defects were found. No. of cases in which delects were : Referred Number of cases in which prosecutions were instituted. Found. Remedied. To H.M. Inspector. By H.M Inspector. Want of cleanliness (S.l) 10 16 1 1 — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) 1 — 1 — — Ineffective drainage of floors (S.6) 1 1 — — — Sanitary Conveniences (S.7)— (a) Insufficient 5 6 — — — (b) Unsuitable or defective 21 54 — 4 — (c) Not separate for sexes — 1 — — — Other offences against the Act (not including offences relating to Outwork) 6 9 — — — Total 44 87 2 5 — 2 Engineering works (Culverting, etc.) * 1 Electrical Station (Sect. 103). 25 Building sites where more than one house erected (including live Corporation sites). 110 Private house sites. OUTWORK: Nil. 39 SANITARY INSPECTION OF THE AREA. Tables VII and VIII in the Appendix give full details of the work carried out by the Sanitary Inspectors during 1955. The following are the aggregate totals under the respective headings:— Total No. of Inspections and Visits. Total No. of Defects and Nuisances found. Housing 4,451 1,134 Infectious Diseases 252 — Food Premises 4,981 278 Factories, Outworkers, etc. 478 96 Sampling Visits 452 — Trade Premises (Various) 614 104 Rodent Control 259 23 Miscellaneous 959 52 Total 12,446 1,687 In addition to the above, there were 1,592 interviews with owners, agents, etc.. on site and at the office, in connection with the above work. Notices issued :— Preliminary: — Housing 587 Food Premises 119 Factories, etc. 23 Trade Premises 48 Rodent Control 526 Miscellaneous 84 1,387 Statutory: — Housing 1 Total 1,388 Food Condemnation Certificates issued 1,160 WATER. Nine samples of drinking water were taken during the year, to ascertain the toxic metal content (zinc). In all samples zinc was not detected. 40 The supply of water for the Borough is provided by the Metropolitan Water Board, and I am indebted to the Director of Water Examination, to that authority, for the following information on the supply during the year 1955:— The supply to the Borough of Bromley is from five of the Board's Kent wells, namely, Deptford, North Orpington, Orpington, Shortlands and West Wickham, together with Thames-derived filtered water. All the water is chlorinated before it leaves the works. Contact tanks are now in operation at all these works to give opportunity for the chlorine to exert its full effect before the water is pumped into supply. Any residual chlorine in the well waters is completely removed before the water leaves the works. Bacteriological analyses of all supplies are made at least five times a week and in the case of the river-derived supply the water is tested bacteriologically at all stages of purification. All new and repaired mains are disinfected with chlorine before being restored to use and samples of water from them are tested to establish that the quality of the water is up to the standard normally supplied. None of the supplies is plumbo-solvent. The closest watch is kept for any evidence of deterioration in quality whether physical, chemical, bacteriological or biological and immediate action is taken if the results of analyses are not up to standard on the works and in the distribution system. The following tables give the average results of the chemical and bacteriological analyses of the various supplies to the area for 1955 Average results of the Chemical and Bacteriological examination of the water supplied to Bromley during the year 1955. (Parts per million unless otherwise stated.) Shortlands Well West Wickham Well Orpington Well North Orpington Well Deptford Well Thamesderived filtered water Chemical No. of samples 10 1 4 4 4 1663 Ammoniacal N itrogen 0.002 Nil Nil 0.003 0.002 0.014 Albuminoid Nitrogen 0.020 0.030 0.019 0.019 0.017 0.085 Oxidised Nitrogen—Nitrate 4.5 5.5 7.5 5.4 7.0 3.8 Chlorides as CI 17 13 15 13 35 26 Oxygen abs. from Permanganate 4 hours at 27°C. 0.08 0.06 0.08 0.07 0.20 1.04 Turbidity in terms of Silica Nil Nil 0.3 Nil Nil 0.2 Colour m.m.brown 2 ft. Tube Burgess's Tintometer Nil Nil 3 Nil Nil 12 Hardness (Total) 272 260 282 265 359 258 Hardness (non-carbonate) 70 35 50 35 126 65 pH Value 7.1 7.5 7.2 7.2 7.1 7.8 Phosphate as P.O4 0.05 — 0.06 0.06 0.09 0.50 Silica as SiO2 — — — — — 10 Sulphates SO4 41 5 13 8 94 49 Conductivity 450 400 425 425 550 450 41  Shortlands Well West Wickham Well Deptford Well Thamesderived filtered water Bacteriological Results Before Chlorination No. of samples Plate count (Average per millilitre) 499 186 249 226 221 7040 Colonies counted on Agar: 37°C. (20-24 hours) 0.04 0.3 50 5.3 2.2 Bact. coli test: Percentage samples negative in 100 ml 100.0 100.0 100.0 25.2 99.6 60.4 Average number per 100 ml — — — 6.80 0.01 3.73 After Chlorination (Water passing into Supply). No. of Samples Plate count (Average per millilitre) 256 208 255 230 225 3561 Colonies counted on Agar: 37°C. (20-24 hours) — — — — — 7.8 Bact. coli test: Percentage samples negative in 100 ml 100.0 100.0 100.0 99.6 100.0 99.9 Average number per 100 ml — — — 0.004 — 0.002 DRAINAGE AND SEWERAGE A further length of the old main soil sewer was reconstructed during the year, involving approximately 470 yards southwards from Magpie Hall Lane. Cesspools. No new houses were erected with cesspool drainage during 1955. Eighteen individual cesspools were emptied by the Borough Engineer's Department upon the request of the householders. RIVERS, STREAMS AND LAKES. The piping of a length of 185 yards of the river Ravensbourne immediately north of Hayes Lane was completed. A contract was let for further culverting of the river at the rear of houses in Newbury Road and immediately north as far as Glassmill Lane. This work was commenced and substantial progress made on the site. The scheme includes the construction of a storage lake on the site of the former mill pond at the rear of the houses in Mill Vale, and the lowering of the invert of the existing culvert under the railway line near Newbury Road. SWIMMING BATHS AND POOLS. The Sanitary Inspectors made a total of 279 visits of inspection to Swimming Baths and Pools in the Borough and forty samples of water were taken for examination. 42 Eight samples were taken from the Corporation Open Air Bath, seven of which were satisfactory and one unsatisfactory. Thirty-two samples were taken from privately owned swimming baths and pools. Thirty-one of these were satisfactory and one unsatisfactory. One hundred and sixty-eight routine colometric tests for checking the efficiency of purification plants were also made by the Inspectors. The chlorine content and pH value are checked by means of a Lovibond Comparator. VERMINOUS CONDITIONS AND UNCLEANLINESS One hundred and seventy-five visits to premises by Sanitary Inspectors related to eradication of bugs, dirty conditions and disinfestations. Forty-six nuisances were found during the year and 30 were abated. PUBLIC CLEANSING, REFUSE COLLECTION AND DISPOSAL. The Borough Engineer informs me that work on modifications to the Refuse Destructor, involving the construction of a new chimney shaft and water seal dust catchers for the new and the existing chimney, was commenced during the year. SMOKE ABATEMENT. Sixty-three visits and re-inspections were made by the Sanitary Inspectors during the year. Four nuisances were confirmed and two were remedied by the end of the year. This Local Authority continues to be a member of the Standing Conference of Co-operating Bodies for the Investigation of Atmospheric Pollution. A representative of the Council and the Chief Sanitary Inspector attend the meetings during the year. The Standing Conference was established to act as a consultative and advisory body to co-operate in the investigation and to promote the practical application in the public interest. Each month the Bromley results of the estimation of sulphur by the lead peroxide method are communicated to the Department of Scientific and Industrial Research. HEATING APPLIANCES (FIREGUARDS) ACT, 1952. Forty visits of inspection were made during the year by the Sanitary Inspectors. Nine contraventions were observed and were remedied. 43 This Act is designed to require fireguards to be fitted to gas tires, electric fires and oil heaters of types so designed that they are suitable for domestic use and so constructed that, without a guard, there is likelihood of injury by burning or of ignition of clothing by reason of contact with or proximity to the heating element or flame. The standards of construction and fitting of guards and the tests to be employed in ascertaining whether guards comply with prescribed standards are controlled by regulations. SHOPS ACT, 1950. Two hundred and sixty-nine visits of inspection were made by the Sanitary Inspectors. Eighty-three contraventions were found and 114 were remedied, which includes those outstanding at the end of the previous year. The infringements were of a minor character—principally the omission of exhibiting the statutory forms. No prosecutions were instituted during the year. It is noticeable that the statutory hours of employment of young persons in the shops were not. in any instances, exceeded. The revised legislation has not yet been implemented. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951. Fifteen informal samples were taken and all conformed to the standard of cleanliness laid down in the Regulations. The main object of this Act is to protect the public. It prevents unclean filling materials being used not only for bedding and upholstery, but toys and other domestic articles. PET ANIMALS ACT, 1951. During the year, seven premises were licensed as pet shops under the above Act. Forty-three visits of inspection were made by the Sanitary Inspectors and three nuisances found, two of these had been abated by the end of the year. 44 DISEASES OF ANIMALS ACTS. Mr. G. R. Woods is the Inspector appointed under the above Acts. This year was, fortunately, free from Swine Fever, Foot and Mouth Disease, Anthrax and Fowl Pest being notified in the Borough. Fifty-four visits and interviews were made by the Animals Acts Inspector. One hundred and eighteen Statutory Orders were received. Three Movement Licences were issued and 84 received. The Statutory Orders were published in accordance with Article 7 of the Animals (Miscellaneous) Provisions (Order), 1927. PREVENTION OF DAMAGE BY PESTS ACT, 1949. Excellent work continues to be performed by the two Assistant Rodent Officers. A free service is now offered to private dwelling houses, but a statutory charge has to be made for rodent work at business premises. There was a change of one personnel during the year. The following tabulation gives details of the work carried out by the rodent control staff during the year ending 31st March. 1956. In addition, six monthly maintenance treatments of the sewers in the area are made. TYPE OF PROPERTY Non-Agricultural Local Authority Dwelling Houses (including Council Houses) All other (including business premises) Total of Cols. (1) (2) & (3) Agricultural (1) (2) (3) (4) (5) I. Number of properlies in Local Authority's District 18 19,577 2,241 21,836 29 II. Number of properties inspected as a result of: (a) Notification, (b) Survey under the Act, (a) 6 623 113 742 4 (c) Otherwise, (e.g., when visited for some other purpose) (b) 1,940 103 2,043 13 (c) 46 126 172 6 III. Total inspections carried out—(including reinspections) 31 6,614 691 7,386 35 45 PETROLEUM (REGULATION) ACTS, 1928 AND 1936. Mr. G. R. Woods is the Inspector appointed under the above Acts. One hundred and twenty-six visits were made in connection with this work. Only a few minor contraventions were found and these were remedied. Ninety-four licences were issued to store Petroleum Spirit and Petroleum Mixtures, and one for Carbide of Calcium. The total storage capacity licensed during the year ending 31st March, 1956, was:— Bulk Storage 126,220 gallons. Can Storage 1,419 gallons. Carbide of Calcium 300 lbs. TYPE OF PROPERTY Non-Agricultural Local Authority (1) Dwelling Houses (including Council Houses) (2) All other (including business premises) (3) Total of Cols. (1) (2) & (3) (4) Agricultural (6) IV. Number of properties inspected (in Sect. II) which were found to be infested by: (a) Rats Major — — — — — Minor 6 436 57 499 4 (b) Mice Major — — — — — Minor 61 45 106 — V. Number of infested properties (in Sect. IV.) treated by Local Authority 6 497 102 605 4 VI. Total treatments carried out—including retreatments 6 553 102 661 4 VII. Number of "Block Control" Schemes carried out — 284 19 303 — New flame proof electrically operated pumps are being gradually installed to replace the old pattern pumps. The electrical wiring is then carried out in accordance with the Home Office Regulations. 46 REGISTRIES FOR FEMALE DOMESTIC SERVANTS. Only two premises are registered in connection with the existing legislation. General observations are made with a view to ascertaining any premises displaying notices of any kind showing that a registry office is carried on at any premises, and if it is found that the proprietor is not registered, the necessary report is made. There are many shops with window advertisement boards which have to be continuously watched for the purpose mentioned. RETAIL MARKET. The Chief Sanitary Inspector, Mr. G. R. Woods, assumed control of the market at the end of January, 1955. It was then evident that the market could be improved and better supervised to the financial benefit of the Local Authority. Mr. Woods made various recommendations to the Health Committee which were adopted as follow :— the roof and louvre back to the open shelter were made watertight, new stall boards and trestles were provided, the area was re-surfaced, additional dustbin accommodation was made available and the layout of the stalls improved to allow for additional stallholders. Constant hot water, liquid soap and paper towels were provided in the lavatories. The takings were doubled within three months, and have been steadily rising since. The Borough Treasurer reported that for the first six years after the war, there was an annual loss on the market which varied from £20 in 1948/1949 to £225 in 1950/1951. Since then there has been an annual surplus, and the balance in hand at the end of March, 1956, was about £375. Each year since the war, the income has steadily increased from £75 in 1945/1946 to £1,149 in the year ended 31st March, 1956. Further improvements which will be suggested are the provision of a further shelter cover for the protection of the public and stallholders during inclement weather, and also the adaptation of a room in the hut for the sale of refreshments. The results of the first year's working under the new administrative arrangements can only be described as startling, and I am most grateful to Mr. Woods whose energy, drive and initiative have contributed so materially to this great success, SECTION D. HOUSING. 48 SECTION D. HOUSING. HOUSING REPAIRS AND RENTS ACT, 1954. Part II of the Act. 1954, allows a landlord to increase the rent of a controlled property providing it is in good repair, and makes further provision for all rents to be increased. This was new in principle and was found rather complicated in application. In last year's report a paragraph stated: "It is not certain whether this part of the Act. referring to the application by tenants for a certificate of disrepair, will be used to the extent originally anticipated." The doubt, therefore, concerning the lack of use by tenants applying for certificates of disrepair is confirmed. Only 10 applications were received in 1955. Six certificates were granted and 4 refused. In addition, of the 8 applications outstanding at the end of 1954. 5 certificates were granted and 3 refused. Eleven applications for revocation of certificates of disrepair were received. Ten were granted and 1 was still under investigation at the end of the year. Three hundred and eleven inspections were made by the Sanitary Inspectors, and 49 nuisances were found. It is hoped that many more owners will afford themselves the advantages of the statutory grant to enable their properties to be improved within the standard envisaged by the Act. HOUSING INSPECTIONS AND ABATEMENTS. During the year, the Sanitary Inspectors made a total of 4.451 inspections relating to housing matters. One thousand one hundred and thirty-four nuisances and defects were found and 1.571 abated (this figure includes those found in 1954 aud remedied during 1955). Detailed information will be found in Tables VII and VIII in the Appendix. Housing Statistics for the year 1955. Total number of valuation assessments, houses and flats at 31st March, 1955 21,433 1. Inspection of dwelling-houses during the year: — (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 498 (b) Number of inspections made for the purpose 3,725 (2) (a) Number of dwelling-houses (included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 — (b) Number of inspections made for the purpose — 49 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 336 2. Remedy of Defects during the year without service of Formal Notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 568 CLEARANCE AREAS—(Housing Act 1936 and Housing Repairs and Rents Act, 1954)— Number of dwelling-houses demolished during the year Nil HOUSES NOT INCLUDED IN CLEARANCE AREAS— (Housing Act, 1936)— (a) Houses demolished as a result of formal or informal procedure (Section II) 3 (b) Parts of building closed (Section 12) 2 Rehousing. I am indebted to the Property Manager for the following information which gives the position as at 1st January, 1956:— PERMANENT HOUSING: Completed and occupied :— Units. Princes Plain 50 Coppice Estate 532 London Road Flats 66 Longfield Flats 27 Tylney Road Flats 54 Bourne Way Flats 66 Hayes Place Estate 339 Hayes Place Estate (O.A.P.) 48 Blackbrook Estate 64 Blackbrook Estate (O.A.P.) 10 Nichol Lane 6 Purchased Properties 55 Havelock Road (O.A.P.) 18 1,335 Under construction:— Bromley Park (O.A.P.) 78 Blyth Road Flats 66 Schemes being prepared:— Martins Road (Re-development) 60 Palace Road (Re-development) 6 Wharton Road (Re-development) 21 Nichol Lane (Re-development) 15 Weston Grove & Weston Road (Re-development) 28 Springfield Site 28 Clarence Road 16 50 TEMPORARY HOUSING: Properties. Units. Occupied. Prefabricated bungalows 321 321 321 Requisitioned properties available for occupation 226 512 512 Half-way houses and camps 6 59 59 553 892 892 Lettings during 1955. 1. (a) No. of permanent houses occupied during 1955:— Re-let 73 New Properties 38 111 (b) No. of families accommodated in permanent houses during 1955 111 (c) No. of persons accommodated in permanent houses during 1955 309 2. No. of premises de-requisitioned during 1955 50 3. No. of families on waiting list as at 31st December, 1955:— Medical category 9 General category 711 O.A.P. 215 Total on waiting list 935 In addition to the above 245 housing units were erected by private enterprise during the year 1955. Moveable Dwellings. During the year the Council granted 3 licences, embracing a total of 26 caravans. The Sanitary Inspectors made a total of 110 visits of inspection to the sites and no nuisances were found. SECTION E. INSPECTION AND SUPERVISION OF FOODS. 52 SECTION E. INSPECTION AND SUPERVISION OF FOODS. This service continued to receive the special attention of the Department during the year and in addition to the 452 visits made in connection with food sampling, the Sanitary Inspectors made 4,981 inspections and re-inspections of food premises. Two hundred and seventy-eight defects were noted and a total of 350 defects remedied during the year—this includes those noted in 1954 and remedied during 1955. Talks were given during the year to various organisations and associations and to people engaged in the handling of food on clean food practices. The co-operation of the shopkeepers, restaurant owners, etc., and the personnel engaged in the preparation and handling of food has been all that could be desired. No formal action was taken by the Council, during the year 1955, under the Byelaws adopted under Section 15 of the Food and Drugs Act, 1938. FOOD SAMPLING—FOOD AND DRUGS ACT, 1938 Samples taken. Result. Article Formal. Informal. Genuine. Inferior. erated. Remarks Apples — l 1 — — Banana Whip — l 1 — — Bean & Pork Sausages in tomato sauce – 1 1 – – Biscuits (Cheese Sandwich) — 2 2 — — Biscuits (Mint Cream) — 1 1 — — Blackcurrant flavoured cordial — 1 1 — — Butter — 7 7 — — Butter Brazils — 1 1 — — Butter Drops — 1 1 — — Butter Flakes — 1 l — — Butter Mints — 1 1 — — Butterscotch — 2 1 1 — See (a) Butter Toffees — 1 1 – — Buttered Macaroons — 1 1 – — Cake Flour — 1 — 1 See (b) Candied Peel — 1 1 – — Celery Seed — 1 1 – — Cereal (strained creamed) — 1 1 – — Cheese Pops — 1 — 1 – See (c) Cheese (Processed) — 1 1 – — Cheese Spread — 1 l – — Chocolate Drink — 1 1 – — Chocolate Mints — 1 1 – — Chocolate Mousse — 1 1 – — Christmas Pudding — 1 1 – — Coffee (Pure) — 1 1 – — Condiment (Non-brewed) — 2 2 – — Cooking Fat — 1 1 – — 53 Article Samples taken. Result. Adulterated Remarks Formal. Informal. Genuine. Inferior. Cottage Cheese — 1 1 — — Cough Candy — 1 1 — — Cream — 2 2 — — Cream (Double) — 5 5 — — Cream (Single) — 1 1 — — Cream (Pure Danish) — 1 1 — — Cream (Pure Devon) — 1 1 — — Cream (Pure Fresh) — 1 1 — — Cream (Pure Sterilized) — 3 3 — — Cream (Sterilized) — 1 1 — — Cream (Danish Sterilized) — 1 1 — — Creamed Bon Bons — 1 1 — — Creamed Rice — 2 2 — — Currants — 4 4 — — Custard Powder — 1 1 — — Dessert Powder — 1 1 — — Figs (Black-Spanish) — 1 1 — — Fish Cakes — 1 1 — — Fish Fingers — 1 1 — — Fondants — 1 1 — — Fruit Pie (Blackcurrant) — 2 2 — — Fruited Jiffi-Jelli — 1 1 — — Garden Mint in Vinegar — 1 1 — — Garden Peas (Canned) — 1 1 — — Gelatine (Granulated) — 2 2 — — Ginger (Stone Milled) — 1 1 — — Gluco Lemon Barley Powder — 1 1 — — Grape Fruit — 4 4 — — Ground Cinnamon — 1 1 — — Ground Nut Oil — 1 1 — — Holland Liqueur Flavoured Filled Chocolate Bottles – 1 1 — — Honey Cake (Dutch) — 1 1 — — Ice Cream (Loose) — 1 1 — — Ice Cream (Choc. Pre-packed) — 2 2 — — Ice Cream (Pre-packed) — 19 15 2 — See (d) Ice Lolly — 5 5 — — Jam (Bramble Jelly) — 1 1 — — Jam (Cherry) — 1 1 — — Jam (Strawberry & Gooseberry) — 1 1 — — Jelly — 1 1 — — Juice of Real Lemon — 1 1 — — Lacta Choc. — 1 1 — — Lard — 2 2 — — Lemon Flavouring — 1 1 — — Lemonade Powder — 1 1 — — Lemons — 6 6 — — Liquid Paraffin — 3 3 — — Luncheon Meat — 2 — 2 — See (e) Margarine — 5 5 — — Margarine (Kosher) — 1 1 — — Marzipan — — — — — Marzipan Selections — — 1 1 — See (f) Meat Pudding (Canned) — 1 1 — — Meringue Powder — 1 1 — — Milk (Pasteurised) — 12 11 1 — See (g) Milk (Pasteurised Homogenised) — 3 3 — — 54 Article Samples taken. Genuine. Result. Inferior. Adulterated Remarks Formal. Informal. Milk (Channel Islands Past.) — 2 2 — — Milk (South Devon Pasteurised) — 2 2 — — Milk (T.T. Pasteurised) — 11 11 — — Milk (Channel Islands T.T. Past.) 1 1 1 — 1 See (h) Milk (Tuberculin Tested) — 1 1 — — Milk (T.T. Farm Bottled) 1 — 1 — — Milk (T.T. Farm Bottled C.I.) — 1 1 — — Milk (Sterilized) — 3 3 — — Milk (Yoghourt) — 2 2 — — Milk (Condensed Full Cream) — 11 9 2 — See (i) Milk (Evaporated) — 2 2 — — Mustard (French) — 1 1 — — Mustard (German) — 1 1 — — Navy Brazils — 1 1 — — Oranges — 8 8 — — Orange Drink (Fresh) — 1 — 1 — See (j) Orange Squash — 1 1 — — Orchard Fruits — 1 1 — — Pepper (Ground White) — 1 1 — — Pepper Flavoured Compound — 1 1 — — Pickling Spice — 1 1 — — Pineapple Slices — 1 1 — — Pomegranates — 1 1 — — Pork & Vegetables — 1 1 — — Potato Puffs — 1 1 — — Rainbow Cream Cups — 1 1 — — Raisins — 2 2 — — Raspberry Tines — 1 1 — — Sausage Meat (Beef) — 1 1 — — Sausages (Beef) — 8 8 — — Sausages (Beef Chipolata) — 1 1 — — Sausages (Cambridge Chipolata) — 1 1 — — Sausages (Pork) — 21 18 3 — See (k) Sausages (Pork Chipolata) — 5 4 1 — See (1) Sausages (Pork & Beef Mixed) — 1 1 — — Sausages (Pork & Veal Chipolata) — 1 1 — — Sherbert Fountain — 1 1 — — Shredded Suet — 2 2 — — Soft Drink Tablets — 1 1 — — Soup — 1 1 — — Soup (Clear Beef) — 1 1 — — Soup (Condensed Tomato) — 1 1 — — Soup (Cream of Celery) — 1 1 — — Soup (Cream of Chicken) — 2 2 — — Soup (Cream of Tomato) — 2 1 1 — See (m) Soup (Dessicated Brown) — 1 1 — — Soup (Kidney) — 1 1 — — Soup (Oxtail Flavour) — 1 1 — — Spaghetti in Tomato Sauce — 1 1 — — Spreading Cheese — 1 — 1 — See (n) Stewed Steak — 1 1 — — Stuffed Pork & Meat Roll — 1 1 — — Sultanas — 3 3 — — Sweet Lollies — 1 1 — — Tea — 1 1 — — Tea Cake Mixture — 1 — 1 — See (o) Tenderising Salt — 1 1 — — 55 Article Samples taken. Result. Adulterated. Remarks Formal. Informal. Genuine. Inferior. Toffees (Mix. Choc. Cream Line) — 1 1 — — Tomato Puree — 1 1 — — Tomatoes — 1 1 — — Treacle Toffee — 1 1 — — Vinegar (Malt) — 5 5 — — Totals 2 295 275 19 1 (a) Inferior—Sample contained Fat 11.9% (Butter 3.7%). Slightly below Code of Practice in butter fat. (b) Inferior—Sugar 25.5%, Avail. C.O.2 0.35. Dried Egg 2.5%. Sugar according to recent Code of Practice should be at least 30%. (c) Inferior—Fat 23.0% (Not more than 0.13% butter fat). Protein 11.0%. Salt 3.4%. So little cheese (probably not more than 0.5%) as not to justify the name. (d) Two samples not analysed due to loss in transit. Inferior—Sample No. 723. Fat 13.8% including no material amount of butter fat. Total solids 41.25%. Sucrose 13.5%. Milk solids 13.7%. Canadian Ice Cream contains at least 10% butter fat. Sample No. 886. Fat 10.6%. Total solids 37.1%. Sugar (Sucrose) 14.0%. N.F.M.S. 11.5%. Contained substantially no butter fat. (e) Inferior—Sample No. 808. Fat 23.0%, lean 45%. Total meat 68%. Low compared with the requirements of 80% in the defunct Meat Products Order. Sample No. 876. Fat 21%, lean 41%. Total meat 62%. (Defunct Meat Products Order required 80%). (0 Inferior—Fat 11.5%, protein 4.98%, Almond content 21%. (Minimum of 25% Almond is expected). (g) Inferior—Sample No. 777. Fat 2.85%, S.N.F. 8.6%. B.U. 1.6 Group 1. Methylene Blue Test—Pass. Deficient 5% minimum amount of fat. (h) Adulterated—Fat 3.4%, Solids not fat 8.9%. B.U. 1.9 Group 1. Methylene Blue Test—Passed. Deficient 15% minimum amount of fat. (i) Inferior—Sample No. 891. Contained 6 small mould buttons and slight deposition of lactose. Sample No. 894. Can and contents normal except for two small mould buttons. (j) Inferior—Total solids 11.05%. Sol. Solids 10.6%. Acidity (= Citric) 0.29%. Vitamin C. 0.88 mg/100 ml. Not fresh, (k) Inferior—Sample No. 634. Fat 27%, Lean 45%. Total meat 72%. Sulphite 75 p.p.m. (not declared). Sample No. 756. Fat 26%, Lean 35%. Total meat 61%. S.O.2. 70 p.p.m. Below former standard. Sample No. 831. Fat 30%, Lean 32%. Total meat 62%. Sulphite 240 p.p.m. Slightly low in meat. (l) Inferior—Sample No. 708. Fat 36%, Lean 28%. Total meat 64%. Fat exceeds lean. Sulphite 230 p.p.m. (m) Inferior—Does not comply with Code of Practice "Dried Milk" as labelled, should be "Dried Skim Milk." Fat 3.0% (containing no butter fat). Total solids 13.7%. Tomato solids 3.3%. 56 (n) Inferior—Fat 25.7%. Moisture 48.5%. Salt 1.2%. Original milk about 3.0% fat. Excessive moisture. (o) Inferior—Sugar 40.0%. Avail. C.0.2. 0.2%. Musty and contained mites. SPECIAL ENQUIRIES. During the year 53 samples of the undermentioned foodstuffs were submitted for bacteriological examination as a result of routine inspections and investigations into complaints made to the department, and enquiries associated with infectious diseases and reported food upsets:— Beef & Tongue Paste Bovine Lungs Calf Liver Chinese Egg Albumen Condensed Milk (Machine Skimmed Sweetened). Danish Cream Egg Powder Egg (Frozen Whole) Egg (Frozen Liquid). Gland of Pig Ice Cream (Pre-packed) Ice Lolly Malt Loaf Milk Bottles (Empty) Milk (Pasteurised) Milk (T.T. Pasteurised) Milk (T.T. Farm Bottled) Milk Chocolate Cocoa-nut Squares Mixed Vegetables Pineapple Juice Pork Chipolatas Rolled Oats Solid Cream Sterilized Cream Synthetic Cream Stuffed Roast Pork Water (Drinking) Water (Spring) Of these samples. 40 were satisfactory and 13 unsatisfactory. Food and Drugs Act, 1938. Section 14. Two hundred and sixty-five shops and food premises have been registered under the above Act. as follow:— Manufacture, Sale or Storage of Ice Cream. Preparation and Manufacture of Preserved Foods etc. Bakers and Caterers 6 — Butchers' Shops — 44 Cinemas 1 — Clubs 2 — Confectioners, Tobacconists, etc. 99 — Dairies/Grocers 10 — Fish Shops (Wet) 2 — Fish Shops (Fried) — 9 Fruiterers and Greengrocers 10 — General Stores 6 — Grocery and Provisions 32 17 Ice Cream Stores 2 — Public Houses 1 — Restaurants, Cafes, Snack Bars, etc 24 — 195 70 57 Two premises are registered for storage and distribution. 1 for the manufacture of. and 192 for the sale of ice cream. Seventy premises are registered for the preparation or manufacture of Preserved Foods, etc. Food Premises. There are some 611 food premises in the area, as under :— 54 Butchers. 35 Bakers and Confectioners. 90 Confectioners. 15 Dairies. 24 Fishmongers, Wet, Dried and Fried. 50 Greengrocers. 110 Grocers. 53 Restaurants, Cafes, etc. 34 School Canteens. 33 Industrial Canteens. 21 Hospitals, Nursing Homes and Old People's Homes. 33 Public Houses. 13 Off Licences. 21 Chemists. 25 Clubs and Hotels. 611 UNSOUND FOOD. During the year a total of 6 tons 4 cwts. 2 qtrs. 26 lbs. of varied articles of food were condemned, and 1,160 Food Condemnation Certificates issued. The main items were :— Fish (Canned) 213 lbs. Fish (Fresh) 607 lbs. Flour 140 lbs. Fruit (Canned) 1,021 lbs. Fruit Juice 71 lbs. Jams and Marmalade 185 lbs. Meat (Raw) and Bacon 8,059 lbs. Meat (Canned) 1,370 lbs. Milk (Canned) 264 lbs. Poultry 380 lbs. Poultry (Canned) 72 lbs. Soups 98 lbs. Vegetables (Canned) 1,127 lbs. Whale Beef 69 lbs. The figures for the year 1954 were 11 tons 19 lbs. of foodstuffs condemned, and 1.062 Condemnation Certificates issued. There was no consignment of food especially examined during the year. Unsound food is normally returned through the Trade, utilised for manufacturing purposes or animal food, or, where this is impracticable, destroyed. 58 MILK AND DAIRIES REGULATIONS. Fourteen Dairies have been registered under the above Regulations. and licences for the year 1955 were issued as under :— Dealers' (Pasteurisers') Licence 1 Dealers' Licences: — " Pasteurised " Milk 14 " Sterilised " Milk 32 " Tuberculin Tested " Milk 14 Supplementary Licences:— " Pasteurised " Milk 14 " Sterilised " Milk 16 " Tuberculin Tested " Milk 14 BACTERIOLOGICAL EXAMINATIONS. Milk. No. of Samples taken. Description. Result Satisfactory. Unsatisfactory 107 Designated Milk 107 — 18 Washed Bottles 18 — — — — 125 125 — — — — Ice Cream. No. of Samples Taken Description Satis. Unsatis. Methylene Blue Group I. II. III. IV 12 Ice Cream (Loose) 12 — 9 1 1 1 26 Ice Cream (Pre-packed) 26 — 24 2 — — 4 Ice Cream (Choc.) 4 — 4 — — — 9 Ice Lollies 8* — 8 — — — — — — 51 50 45 3 1 1 — — — — — — * One sample unsuitable for lest. More acid than pH4. Twenty-five samples were submitted for Chemical examination, the lowest fat content being 4.15% (Ice Lolly containing Ice Cream), and the highest 18.9%. The following tabulation shows the results obtained in respect of the 997 samples examined from 1st May. 1947. to 31st December. 1955. The standard of ice cream remains at a high level, and in no instance have pathogenic organisms been cultivated in any sample examined since the inception of the tests in 1947. 59 Year Grade I No. of Samples % Grade II No. of Samples % Grade III No. of Samples % Grade IV No. of Samples % "total No. of Samples 1947 ,... 13 17.8 18 24.6 17 23.3 25 34.3 73 1948 .... 46 40.0 24 20.9 19 16.5 26 22.6 115 1949 ,... 108 53.0 52 25.5 28 13.7 16 7.8 204 1950 . .. 97 50.5 41 21.4 39 20.3 15 7.8 192 1951 .... 110 84.0 11 8.4 8 6.1 2 1.5 131 1952 .... 79 77.5 14 13.7 6 5.9 3 2.9 102 1953 .... 72 74.2 15 15.5 10 10.3 — — 97 1954 .... 36 94.7 2 5.3 — — — — 38 1955 .... 45 90.0 3 6.0 1 2.0 1 2.0 50 MEAT INSPECTION. Annual licences were granted to 5 slaughtermen during 1955. and the licence of one private slaughterhouse was also renewed during the year. The following table gives details of the ante and post-mortem inspection of animals made during 1955 :— Carcases Inspected and Condemned. e Cattle xcluding Cows Cows Calves Sheep and Lambs Pigs Number killed 74 2 52 441 170 Number inspected 74 2 52 441 170 All diseases except tuberculosis: Whole carcases condemned Carcases of which some part or organ was condemned 28 2 1 13 12 Percentage of the number inspected affected with disease other than tuberculosis 37.8 100 1.9 2.9 7.1 Tuberculosis only: Whole carcases condemned ... Carcases of which some part or organ was condemned Percentage of the number inspected affected with tuberculosis 6b The main object of the Act is to ensure that certain imported foodstuffs offered or exposed for sale must bear an indication of origin in accordance with the requirements of the Order made thereunder. The contraventions mentioned above refer to the exposure for sale of imported tomatoes not suitably marked. The Tomato and Cucumber Marketing Board have appointed area officers whose advice may be sought if there is a flagrant non-compliance with the statutory provisions concerning tomatoes. GAME ACT, 1831. Seventeen licences were issued during the year for dealers in Game to use premises in the district. SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. 62 SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. GENERAL. A total of 1,033 cases of infectious diseases (excluding tuberculosis) were notified, as against 624 during 1954, and this state of affairs was largely brought about by the considerable increase in the incidence of measles during the year under discussion. Although the number of cases of this disease was large, the vast majority of them were uncomplicated and did not give rise to any undue alarm. Compared with some other places in the country, we must be considered fortunate to have had only 14 confirmed cases of infantile paralysis, of which only 5 were paralytic, but, unfortunately, there was 1 death. In addition, 11 further cases were notified but on investigation none of these could be confirmed. There was, therefore a total of 25 cases under suspicion during the course of the year. One hundred and twenty-four cases of Whooping Cough. 51 of Scarlet Fever, 14 of Dysentery and 4 of Food Poisoning came to light during the year and these, in conjunction with the cases of measles and infantile paralysis, accounted for most of the infectious disease notifications received during 1955, but statistical details of notifiable infectious diseases will be found in Tables V and VI in the Appendix. ACUTE ANTERIOR POLIOMYELITIS. The first case of this disease to occur arose in the spring and was the only one which eventually proved fatal. No further notifications were received until July and this case was not confirmed, but towards the end of August notifications were being received fairly regularly until the end of October, after which there was a lull throughout November. In December an unexpected development was the notification of a further 4 cases. 3 of which were confirmed. Further analysing these cases, we find that 3 of the 5 paralytic ones were of the Bulbar type, that 9 cases were non-paralytic, and that of the total of 25 notifications received during the year. 11 eventually proved to be other illnesses. An unsually high percentage of the paralytic cases were bulbar in type, but from what I can glean from various sources, this seems to have been a fairly general experience throughout the country during the recent outbreak. Exclusion of contacts, except in the case of school children, is not a routine automatic procedure and a number of rather difficult decisions on the necessity or otherwise for this action had to be 63 made during the year, especially in view of the number of cases arising which were often the subject of quite considerable delay before a definite diagnosis of acute poliomyelitis could be confirmed. There is one other feature of this disease to which attention should be drawn, and that is. that only 6 of the 14 confirmed cases referred to children of school age. Of the remaining 8, 4 were adults and 4 under school age. This tends to confirm a national tendency for the disease to attack the adult to a greater extent and therefore to make the designation of " infantile paralysis " somewhat of a misnomer. DIPHTHERIA. For the fifth year in succession, no case occurred in the Borough, and the continued very low incidence of this disease in the country as a whole is one of the major triumphs of preventive medicine. The present position with regard to immunisation against this disease is summarised in the following figures which have been supplied by the County Medical Officer. Of the children resident in the area who were born since 1941. a total of 649 received primary inoculations and 1.046 received reinforcing inoculations during 1955. A total of 10.173 children under the age of 15 years have completed a course of immunisation at some time prior to 31st December. 1955. DYSENTERY. This disease continues to be endemic and although generally of a mild type 3 cases out of the 14 notified were sufficiently bad to necessitate admission to hospital. FOOD POISONING. Only 4 cases of food poisoning were notified during the year and in 3 of them the causative organism was discovered. On paper these figures are very good, but the fact remains that one must admit there is no justification for complacency. It is inevitable that a considerable number of such cases will never come to the notice of a medical practitioner and it is. therefore, necessary to state that the actual number of cases occurring probably bears little relation to the number notified. It appears very desirable to draw attention to this point in order to encourage the highest possible standard of kitchen hygiene in all walks of life, otherwise, with so few " official" cases to report, there might be a tendency to minimise the importance of those very vital operations. MEASLES. The year 1955 produced a large epidemic of measles and in Bromley 760 cases were notified, but it is a commentary on the 64 mildness of the condition that only 2 of these cases necessitated hospital admission. In the previous year 209 cases were notified but most of these occurred at the end of the year and were part of the same epidemic. It is highly probable that the number of actual cases was greater than this, but as always occurs when an infection is mild, a certain number of cases never receive any medical attention and so miss being notified. No death from the disease occurred in the area. PNEUMONIA. During the year 23 cases were notified, a drop of 8 compared with the previous year. There were 44 deaths from pneumonia. This figure includes people who died in other areas, but who are normally resident in the Borough. SCARLET FEVER. Scarlet Fever continues to be a mild infection with the occasional severe case cropping up for no apparent reason. There is little doubt that, generally speaking, the disease has so lost its terrors, that there must be quite a number of missed cases. Every year there must be people who get sore throats with rashes so slight and trivial that the latter are not even noticed and it is well to remember that an attack of tonsillitis without a rash can often be a much more serious illness than the modern type of scarlet fever. During the year. 51 cases were notified, of which only 6 had to be removed to hospital. In the previous year 60 cases were notified so the overall position differed very little between the two years. There were no " return " cases, and no deaths notified. SMALLPOX. The continued absence of this disease is a cause for congratulation and thankfulness, but we have to be constantly on our guard against its importation with the ever increasing speed of travel between different parts of the world. During the course of the year several suspected contacts of cases in other parts of the world came under the supervision of the department, but in no case did anything develop. There is also a steady call on the department to stamp and sign International Certificates of Vaccination, which are not valid until so countersigned. Every year re-vaccination is offered to all members of the staff of the Health Department. I am indebted to the County Medical Officer for the following figures showing the current position with regard to vaccination in Bromley. A total of 573 residents received Primary vaccination and 106 Re-vaccination during 1955. 65 TUBERCULOSIS. The following are details of the recordings in the Register for the year ended 31st December, 1955 :— Respiratory. Other forms. Total number of cases. M. F. M. F. On Register at 1/1/55 435 359 46 58 898 New cases notified during 1955 27 19 — 2 48 Number of cases coming to knowledge after death 1 1 2 Restored to Register — 1 — 1 Inward Transfers 15 23 — — 38 Deletions, deaths, removals, 478 403 46 60 987 recoveries, etc 24 19 — 2 45 Number of cases on Register at 31st December, 1955 .... 454 384 46 58 942 66 With the ever increasing ease and certainty with which pulmonary tuberculosis is diagnosed, it is encouraging to record a fairly steady decline in the number of new cases being notified year by year. As will be seen from the above table, newly diagnosed cases in the area during 1955 numbered 51. which compares with 48 in 1954. 69 in 1953, and 83 in 1952. That we should get such a decline over such a comparatively short period is a very healthy sign and. taking into consideration the fact that modern diagnostic facilities tend to make the disease discovered at an earlier stage than formerly, augurs well for the future. As a general rule it can be said that the earlier a case is recognised, the shorter the period of treatment, with a corresponding reduction in the period of possible infectivity to others. MASS X-RAY. A very close and satisfactory liaison exists between this department and Dr. J. M. Morgan, the Director of the Mass X-Ray Unit of the South Eastern Regional Hospital Board, which operates from time to time in this area, and I am very grateful to him and his staff especially for supplying me with the statistics upon which the following information is based. During the year, 8,811 people were x-rayed, of whom 5.778 were women, and of the grand total as many as 4,170 had previously taken advantage of this service. Of the 180 abnormalities discovered, 90 required no action, and 41 were considered tuberculous. Of this latter group, 19 required treatment, 18 needed occasional supervision only, and the remaining 4 are still under investigation. The rest of the 180 consisted of non-tuberculous chest conditions, cardiac abnormalities and a few previously known tuberculous cases. Whilst these figures show that there would appear to be some 4,170 persons who have recognised the value of regular examination of this type, there were only 4,641 new converts, and it is safe to say that a much higher percentage of people will have to be encouraged to co-operate with this service if we are to succeed in our aim of the eventual elimination of the scourge of tuberculosis from our midst. For information, the number x-rayed at previous visits of the unit were :— Year. Number. 1951 6,970 1953 5,577 67 CHEST CLINIC. Dr. D. G. Madigan. Physician in charge, has kindly furnished the following details :— New cases attending Chest Clinic for the first time during 1955 :— Adults. Children. M. F. M. F. Pulmonary Tuberculosis 41 26 1 — Non-Pulmonary Tuberculosis .... — 1 — — Non-Tuberculous 34 53 7 9 New Contacts examined during 1955. Negative. Positive. M. 95 F. 130 M. F. 1 (These contact figures are not included in the first table.) B.C.G. Vaccination of contacts : 99. Number of patients who completed a course of sanatorium or hospital treatment during 1955 : 58. BROMLEY TUBERCULOSIS CARE COMMITTEE I am indebted to the Secretary of the above Committee for the following report in respect of the year 1955. During the year approximately 69 visits were made by our Liaison Officer to tuberculous patients and their families in the area. These visits were made with a view to ascertaining what assistance was urgently required. Each month the Liaison Officer reports to the Care Committee who. after giving full consideration to the case, decide the assistance to be given not only to the tuberculous patient, but also to the household which has been exposed to the risk of tuberculosis. Again this year help has been given in the payment of coal bills, provision of extra nourishment, clothing, blankets and bedding, fares for visits by relatives to patients in Sanatoria, holidays both in this country and, in a few instances, abroad. Recently rehabilitation has been encouraged to provide an interest for patients and to equip them for suitable employment on their recovery. To sum up, it is the Care Committee's earnest desire not only to provide, where possible, for the physical needs of the patients, but also to relieve their minds of any anxieties associated with their homes and families. TYPHOID FEVER. One solitary case of para-typhoid fever was notified during the year and this was imported by a recent arrival by air from the Far East. The case was treated in hospital and made a good recovery. 68 WHOOPING COUGH. This is another of those diseases which at least temporarily, and one hopes permanently, has lost a great deal of its former virulence. Of 124 cases notified, only 1 had to be treated in hospital. There was a large drop in the incidence of this disease compared with the previous year when 251 cases were notified but, once again, this is a condition in which one does not expect to get one hundred per cent notification as it is often so mild that it is either missed altogether or else diagnosis is so difficult that a firm decision is never reached. No death from this disease occurred in the area during the year. OTHER INFECTIOUS DISEASES In addition to those previously mentioned, notifications were received as under :— Erysipelas .... 9 cases (2 were removed to hospital). Puerperal Pyrexia .... 33 cases (all of these occurred in hospitals). APPENDIX STATISTICAL TABLES. 70 STATISTICAL TABLES, 1955. TABLE I.—Summary of Statistics. TABLE II.—Causes of Death. TABLE III.—Infant Mortality. TABLE IV.—Analysis of Causes of Infant Deaths. TABLE V.—Notifiable Infectious Diseases—Ward Distribution. Attack and Mortality Rates. TABLE VI.—Notifiable Infectious Diseases—Seasonal Incidence. TABLE VII.—Summary of the work of the Sanitary Inspectors TABLE VIII.—Nuisances. Defects and Contraventions Abated. 71 TABLE I. Summary of Statistics, 1955. Population (mid-year 1955, per Registrar General) 64,780 Birth Rate (crude) 12-7 Death Rate (crude) 11-4 Maternal Mortality Rate Nil Infant Mortality Rite 31-6 Number of Births (Live) 823 Number of Stillbirths 11 Number of Deaths 741 Number of Maternal Deaths Nil Number of Infant Deaths (under 1 year) 26 Death Rates:—Respiratory Diseases 1*5 Tuberculosis 008 Cancer (all forms) 1-84 Cancer of the Lung 0-39 Zymotic Diseases 003 Notifications of Infectious Diseases: Diphtheria Nil Dysentery 14 Erysipelas 9 Food Poisoning 4 Measles 760 Pneumonia (all forms) 23 Poliomyelitis (paralytic) 5 Poliomyelitis (non-paralytic) 9 Puerperal Pyrexia 33 Scarlet Fever 51 Tuberculosis (new cases and including inward transfers) 86 Typhoid and Para-Typhoid Fever 1 Whooping Cough 124 Number of Deaths from Infectious Diseases 2 „ Diarrhoea (under 2 years of age) Nil Number of visits made by Sanitary Inspectors 12,446 '72 TABLE II. Causes of Death. • 1951 1952 1953 1954 Male 1955 Female Total 1. Tuberculosis—Respiratory 18 11 8 7 4 1 5 2. „ Other 2 — 1 1 3. Syphilitic diseases 6 3 1 4 1 1 4. Diphtheria — — — 5. Whooping Cough — — — — 6. Meningococcal Infections — — I 7. Acute Poliomyelitis — 1 — — — 1 1 8. Measles 1 — — — 9. Other infective and parasitic diseases 3 1 1 2 1 1 10. Malignant neoplasm, stomach .... 21 24 21 12 6 10 16 11. Malignant neoplasm, lung bronchus 22 14 29 28 19 6 25 12. Malignant neoplasm, breast 12 11 20 18 — 13 13 13. Malignant neoplasm, uterus 8 3 6 6 4 4 14. Other malignant and lymphatic neoplasms 65 62 78 65 28 33 61 15. Leukaemia, Aleukaemia 2 4 3 9 2 4 6 16. Diabetes 6 3 7 4 1 4 5 17. Vascular lesions of nervous system 84 102 86 94 43 70 113 18. Coronary disease, angina 80 104 116 125 63 49 112 19. Hypertension with heart disease .... 38 13 16 18 4 8 12 20. Other heart disease 133 143 102 103 32 75 107 21. Other circulatory diseases 24 44 25 41 15 26 41 22. Influenza 7 — 7 1 — — — 23. Pneumonia 31 30 22 34 16 28 44 24. Bronchitis 40 39 30 28 25 14 39 25. Other diseases of the respiratory system 11 6 7 9 3 3 6 26. Ulcer of stomach and duodenum 13 9 4 11 6 2 8 27. Gastritis, enteritis & diarrhoea .... 2 1 4 3 — 4 4 28. Nephritis and nephrosis 4 5 7 4 3 2 5 29. Hyperplasia of prostate 8 11 3 11 7 — 7 30. Pregnancy, childbirth, abortion .... — — — — — — — 31. Congenital malformations 6 10 7 5 2 5 7 32. Other defined and ill-defined diseases 59 47 62 65 42 38 80 33. Motor vehicle accidents 7 5 5 5 4 — 4 34. All other accidents 15 8 8 7 4 3 7 35. Suicide 6 6 5 7 5 2 7 36. Homicide and operations of war 1 — — — — — — All causes .... 735 720 692 727 336 405 741 « TABLE III. Infantile Mortality, 1955. (Compiled locally from Registrar's Death Returns) CAUSES OF DEATH Under 1 Week 1 and under 2 Weeks 2 and under 3 Weeks 3 and under 4 Weeks Total under 4 Weeks 1 month and under 3 Months 3 months and under 6 Months 6 Months and under 9 Months 9 Months and under 12 Months Total Deaths under 1 year Acute Bronchitis 1 — 1 Broncho-Pneumonia — — — — — 1 1 1 1 4 Gastroenteritis .... ... — — — — — — — — — — Malformation... — — — — — — — — — — Prematurity ... 8 — - — 8 — — — — 8 Other Causes 9 i 2 — 12 — 1 — — 13 Totals 17 i 2 - 20 1 3 1 1 26 74 TABLE IV. Analysis of Causes of Infant Deaths. 1946 -1955. 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 Total No. of Births (live) 1,176 1,308 1,042 1,030 892 916 908 880 824 823 9,799 Infant Mortality Rate (per 1,000 Live Births) 26.3 19.11 20.15 15.5 21.3 12.0 22.0 14.8 20.6 31.6 20.3 Malformation 3 13 — — — 1 — — — 17 Prematurity 14 5 6 3 5 3 3 5 8 8 60 Respiratory Diseases 4 5 2 1 4 2 7 2 4 5 36 Infectious Diseases 1 — — 3 - 1 — — — 5 Gastro Enteritis — — 1 1 — — 3 — — 5 Atelectasis — - - 1 1 1 1 - 1 5 10 Congenital Heart Disease — — — 3 4 — 5 1 — 3 16 Other Causes 9 2 12 4 5 3 4 2 4 5 50 Totals 31 25 21 16 19 11 20 13 17 26 199 75 TABLE V. Notifiable Infectious Diseases, 1955 Ward Distribution, Attack and Mortality Rate. Disease Total WARDS Cases removed to Hospital Attack Rate per 1,000 population No. of Deaths Death Rate per 1,000 population Plaistow Martins Hill Town Sundridge Bickley Bromley Common Keston and Hayes Scarlet Fever 51 4 2 2 5 5 20 13 6 0.79 — — Whooping Cough 124 9 9 3 12 16 28 47 1 1.91 — Acute Poliomyelitis (paralytic) 5 1 — — 1 1 1 1 5 0.08 1 0.015 „ „ (Non-Paralytic) 9 3 1 — 2 — — 3 9 0.14 — — Measles 760 131 87 48 82 89 143 180 2 11.73 — — Diphtheria - - - - - - - - — - - - Acute Pneumonia 23 1 3 5 3 1 10 — 6 0.35‡ 44 0.68 Dysentery 14 — — 1 2 - 7 4 3 0.22 - - Erysipelas 9 — 1 - - 2 6 - 2 0.14 - - Cerebro Spinal Fever — — — — - — — — - - — - Puerperal Pyrexia 33 — - 32 - - 1 — 32 39.57§ - - Typhoid & Paratyphoid Fever 1 - 1 - - - - - 1 0 .015 — - Tuberculosis (Pulmonary) 87 18 8 10 7 8 19 17 17 1.34 5 0.08 ,, (Non-Pulmonary) 2 — — — 2 — — — 2 0.03 — — Food Poisoning 4 - — - 3 — 1 - 1 0 .06 — — Ophthalmia Neonatorum — — — — — — — — — — — — Malaria - - - - - - - - - - - Totals ... 1122 167 112 101 119 122 236 265 87 17.32 50 0.77 ‡ Includes Pneumonia (all forms). § Based on attack rate per 1,000 total births, and not population. 16 TABLE VI. Notifiable Infectious Diseases, 1955—Seasonal Incidence. Disease Jan. Feb. Mch. Apl. May June July Aug. Sept. Oct. Nov. Dec. Total Scarlet Fever 3 4 12 6 7 8 3 — 2 3 2 1 51 Diphtheria — — — — — — — — — — — — — Measles 89 156 141 216 67 54 27 7 2 — - 1 760 Whooping Cough 30 26 22 11 11 6 4 13 - - — 1 124 Dysentery 1 - — 6 1 - 4 1 - - - 1 14 Erysipelas 2 1 - - 1 — 1 — 2 1 — 1 9 Cerebro-Spinal Fever — — — — — — — — — — — — — Pneumonia (all forms) 2 7 5 2 2 2 - - — 1 1 1 23 Typhoid & Paratyphoid Fever - — — — — 1 — - - — — — 1 Acute Anterior Poliomyelitis — - — 1 - — — 2 8 — — 3 14 Food Poisoning — 1 — - 1 1 _ — 1 - - — 4 Puerperal Pyrexia 3 1 4 2 8 1 4 — 3 1 3 3 33 Totals 130 196 184 244 98 73 43 23 18 6 6 12 1033 77 TABLE VII. Summary of the Work of the Sanitary Inspectors for the year 1955. TYPE OF INSPECTION. On Complaint Routine ReInspec tion Total Visits Nuisances Found Housing 1. Inspection of District Regulations 1 18 10 29 2 2. For Nuisances 719 171 2,836 3,725 1,012 3. Overcrowding 20 80 24 124 4 4. Verminous Conditions 21 12 24 57 19 5. Dirty Conditions 15 12 20 47 6 6. Water Supply 2 1 1 4 1 7. Cesspools 1 2 2 5 1 8. Earth Closets — — — — — 9. Privy Pails — 1 — 1 1 10. Houses Let in Lodgings 1 — 1 2 3 11. Disinfestations 23 18 30 71 21 12. Noxious Accumulations 6 4 14 24 4 13. Other Accumulations 12 8 31 51 11 14. Housing Repairs & Rents Act 14 116 181 311 49 Totals 835 443 3,173 4,451 1,134 Infectious Diseases- 1. Inquiry Visits (Nuisances found recorded in above table) — 108 28 136 — 2. Disinfection Purposes — 44 11 55 — 3. Smallpox Inquiries — 7 10 17 — 4. Public Health (Aircraft) Regulations — — — — — 5. Food Poisoning 5 20 19 44 — Totals 5 179 68 852 - Meat, Milk and Other Foods etc.— 1. Butchers and Wholesale Depots 7 1,270 35 1,312 43 2. Confectionery 1 144 22 167 13 3. Dairies and Cowsheds (excl. Past. Plants)... 1 52 2 55 — 4. Pasteurising Plants — 56 — 56 — 5. Fish 3 229 7 239 1 6. Fried Fish — 77 10 87 5 7. Food Hawkers — 75 8 83 9 8. Fruit Greengrocery — 241 20 261 13 9. Grocery 8 453 57 518 47 10. Ice Cream Shops — 169 12 181 9 11. Meat Regulations (Special Visits) — 13 — 13 — 12. Milk Examined on Highway — 1 — 1 — 13. Retail Market — 100 196 296 7 14. Slaughterhouses 1 107 1 109 — 15. Horseflesh Shops — 72 — 72 — 16. Restaurants & Hotels 3 114 44 161 64 17. School Canteens & Others 5 39 9 53 9 18. Public Houses 1 12 12 25 3 19. Food Wholesaler 1 145 — 146 — 20. Clean Food Byelaws — 712 104 816 15 21. Hospital Food Store and Kitchen 1 2 4 7 — Merchandise Marks Act — 231 16 247 10 23. Food Preserving Premises — 8 10 18 — 24. Bakehouses (other than Factory Act) 3 34 21 58 30 Totals 35 4,356 590 4,981 278 Factories, Outworkers, etc.— 1. (i) Factories in which Sects. 1, 2, 3, 4 and 6 of the Factories Act 1937 are to be enforced by the Local Authority 1 27 11 39 15 (ii) Factories not included in (i) to which Section 7 applies 6 78 65 149 42 Carried Forward 7 105 76 188 57 78 TABLE VII. (Continued) Type of Inspection On Complaint Routine ReInspec tion Total Visits Nuisances Found Brought Forward 7 105 76 188 57 Factories, Outworkers, etc. Contd.— (a) Subject to Local Authority (transfer of Enforcement) Order, 1938 — — — — — (b) Others — 4 4 8 — 2. Other Premises under the Act (excl. outworkers' premises, hotels, Restaurants,etc.) 1 37 23 61 12 3. Bakehouses (a) Mech. power 1 20 28 49 14 (b) Non-mech. power — — — — — 4. Outworkers' premises — 49 20 69 — 5. Smoke Abatement 8 35 20 63 4 6. Fireguards Act — 33 7 40 9 Totals 17 283 178 478 96 Sampling of Food and Drugs, etc.— 1. Milk: T.T. Certified — 1 — 1 — T.T. Pasteurised 1 26 — 27 — Pasteurised — 36 — 36 — T.T. Bottled — 4 — 4 — Sterilised — 5 — 5 — Channel Islands T.T. — 2 — 2 — Pasteurised — — — — — 2. Schools Milk (Pasteurised) 1 10 6 17 — 3. Pasteurising Plant: T.T. Milk — 16 — 16 — Pasteurised — 22 — 22 — Washed Bottle 1 8 — 9 — 4. Tinned Milk — 3 — 3 — Condensed Milk — 13 — 13 — 5. Dried Milk 1 2 — 6 — 6. Ice Cream — 56 — 56 — Ice Cream Mix — — — — 7. Cream 1 9 — 10 8. Other Foods 14 151 19 184 — 9. Food Poisoning 1 3 4 8 10. Drinking Water 4 20 — 24 11. Water (Stream and Paddling Pool) 2 — — 2 12. Rag Flock — 10 — 10 13. Court Cases - — — — — Totals 26 397 29 452 - Trade Premises Various— 1. Under Shops Act 15 159 95 269 83 2. Under Petroleum Acts — 39 87 126 — 3. Registry Offices 2 34 9 45 7 4. Offices (P.H. Act 1936, Sees. 46 and 91) — — — — — 5. Pet Animals Act — 32 11 43 3 6. Rag Flock and Other Filling Materials Act — 11 3 14 — 7. Merchandise Marks Act — 30 3 33 2 8. Diseases of Animals Acts: Movement Licences — 3 — 3 — Foot and Mouth Disease — — — — — Swine Fever — — — — — Fowl Pest — — — — — Anthrax — — — — — Other — 1 — 1 — Interviews — 20 — 20 — 9. Piggeries, Cleansing 4 19 2 25 6 Sanitary Conditions 1 5 3 9 1 10. Stables: Cleansing — 9 1 10 — Sanitary Conditions — 5 1 6 — 11. Animals, Keeping of 4 4 2 10 2 12. Poultry Farms — — — — — Totals 26 371 217 614 104 79 TABLE VII. (Continued) TYPE OF INSPECTION On Complaint Routine ReInspec tion Total Visits Nuisances Found Rodent Control— 1. Trade Premises 11 135 42 188 14 2 Private Premises 26 22 19 67 9 3. Agricultural Premises — — — — — 4. Sewers 3 1 — 4 — Totals 40 158 61 259 23 Miscellaneous- 1. Schools 3 10 13 26 2 2. Drain Tests: Smoke 5 14 2 21 2 Water 2 45 3 50 2 Colour 5 9 6 20 5 Chemical 1 — — 1 — Mirror — — — 3. Swimming Baths: Visited — 69 2 71 2 Samples taken — 40 — 40 — Chlorine & Ph. Test — 168 — 168 — 4. Tents, Vans, Sheds, Caravans and Fairgrounds — 109 1 110 — 5. Accumulations (other than dwellings) 6 17 54 77 14 6. Streams, Ponds and Watercourses 4 41 9 54 5 7. Tips 1 5 6 12 2 8. Special Visits 26 158 38 222 4 9. Public Houses—Urinals 1 42 18 61 7 10. Exhumations — — — — — 11. Cinemas, Theatres etc. 1 7 18 26 7 Totals 55 734 170 959 52 Grand Totals 1,039 6,921 4,486 12,446 1,687 80 TABLE VIII. Nuisances, Defects, Contraventions, etc., Abated or Remedied in 1955. HOUSING Drainage- Premises re-drained and connected to sewer — Cesspools abolished — Earth closets abolished — Cesspools emptied 1 Privy pails, etc., abolished — Drains relaid or repaired 77 Drains unstopped 143 New Covers to Inspection Chambers 1 Inspection chambers provided 14 Stopper provided to Intercepter 1 W.C's. provided (additional or separate) 6 „ buildings reconstructed 1 „ „ repaired 14 ,, pans renewed 23 „ „ cleansed 6 „ box seats removed 2 „ seats repaired — Soil vent pipes renewed or repaired 16 Sink/bath waste pipes renewed or repaired 21 Sinks renewed 8 Lavatory basins renewed or repaired 5 Baths renewed or repaired 3 Miscellaneous 11 853 Dampness- Roofs repaired or renewed 112 R.w.p.'s, guttering, repaired or renewed 98 Vertical Plinth provided 14 Walls rendered 41 Horizontal damp-course provided 12 Solutioning 5 Earth removed from walls 14 Walls repointed 31 Weather-board walls repaired 3 Sub-floor ventilation provided or improved 24 Dry areas constructed 4 Brickwork repaired 18 Miscellaneous 25 401 Water Supply- Drinking water service supplied direct from main — Fittings, etc. renewed 12 Separate or additional water supply provided — Supply reinstated 5 Flushing cisterns renewed or repaired 23 Storage tanks 3 Boilers „ „ „ — 43 81 TABLE VIII. (Continued) General Items— Rooms cleansed 79 W.C. walls cleansed 6 Entrance hall and staircase cleansed 8 Bathroom cleansed 1 Light and ventilation improved 2 Plastering repaired or renewed 206 Floors repaired or renewed 52 Windows, frames, etc. repaired or renewed 92 Sashcords repaired or renewed 44 Putty pointing repaired or renewed 11 Doors repaired or renewed 19 Stoves and grates repaired or renewed 17 Coppers repaired or renewed 2 Draining Board renewed — Iron Staircase renewed — Handrails repaired or renewed 5 Stairtreads repaired or renewed 10 Dustbins provided 87 Dirty conditions remedied 7 Overcrowding abated — Chimneys repaired 16 External woodwork repainted 6 Food stores provided — Food stores ventilated — Yard paving renewed, etc. 14 Houses disinfested 23 Accumulations removed 34 Fencing 1 Miscellaneous 32 774 MEAT, MILK AND OTHER FOOD PREMISES- Yard floors, repaired, etc. 12 Cleansed, lime-washed shops, rooms 92 Lighting/Ventilation improved 7 Drains improved 5 Manure or refuse removed 18 Refuse bins provided 32 Cold store or refrigerator improved 11 Water supply improved 8 Sinks provided 13 Washing facilities improved 27 Sanitary conveniences improved 22 Miscellaneous 103 350 FACTORIES, OUTWORKERS. Etc.— Want of Cleanliness (Sect. 1) 16 Overcrowding (Sect. 2) — Unreasonable temperature (Sect. 3) — Inadequate ventilation (Sect. 4) — Ineffective drainage of floors (Sect. 6) 1 Sanitary conveniences (Sect. 7): (a) Insufficient 6 (b) Unsuitable or defective 54 (c) Not separate for sexes 1 Other offences 9 Outworkers' premises — Smoke nuisances 2 89 82 TABLE VIII. (Continued) TRADE PREMISES— Shops Act: Ventilation improved - Temperature improved 6 Sanitary conveniences improved 3 Absence of statutory forms 90 Unsatisfactory Washing facilities remedied 3 Meals rest interval contraventions remedied 1 Seats for female workers provided — Other offences or defects remedied 5 Petroleum Acts contraventions — Registry Office contraventions 6 Offices (P.H. Act, 1936, Sects. 46 and 91) contraventions — Pet Animals Act 2 Merchandise Marks Act 10 132 RODENT CONTROL— Trade premises 110 Private premises 414 Sewers (manholes) 177 Corporation property 6 707 MISCELLANEOUS— Diseases of Animals Acts: Piggeries—Cleansing — Piggeries—Sanitary Conditions 1 Stables—Cleansing — Stables—Sanitary Conditions — Animals, Keeping of 1 Poultry Farms — Schools 2 Drain tests: Smoke — Water 1 Colour — Swimming Baths—visited — Tents, Vans Sheds, Caravans and Fairgrounds 1 Accumulations (other than dwellings) 13 Streams, Ponds and Watercourses 3 Tips — Public Houses—Urinals 5 Cinemas, Theatres etc. 4 Fireguards Act 9 40 Grand Total 2,879 NOTICES ISSUED— Preliminary: Housing 587 Food Premises 119 Factories 23 Trade Premises 48 Rodent Control 526 Miscellaneous 84 1,387 Statutory—Housing 1 1,388 BOROUGH OF BROMLEY COMMITTEE FOR EDUCATION ANNUAL REPORT on the SCHOOL HEALTH SERVICES for 1955 H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H, January, 1956 84 EXCEPTED DISTRICT OF BROMLEY. Members of the Committee for Education. The Mayor (Alderman Samuel Lane, J.P.) (Vice-Chairman) Alderman F. W. Isard (Chairman) Alderman J. S. Marriott Councillor R. N. Allen Councillor S. L. Best Councillor G. W. Brown, M.B.E. *Councillor J. C. Clayton Councillor W. K. Curtis *Councillor A. D. Daysh *Councillor M. L. Dempster (Mrs.) *Councillor H. F. Goodway *Councillor J. L. Hunt (Chairman of the Welfare Sub-Committee) *Councillor L. M. Prince (Mrs.) *Councillor C. W. Wilmot *Mrs. S. G. W. Baylis Mrs. A. J. Howe, J.P. Mr. Leighton L. Irwin, M.A., LL.B., J.P. Miss O. M. Lambert, M.A. Professor E. F. D. Witchell, B.Sc., F.C.G.I., M.I.Mech.E. Mr. J. Davies Mr. G. J. Gully, C.B.E., J.P. (* Denotes members of Welfare Sub-Committee) Officers of the Committee. Borough Education Officer: H. T. Smith, M.A. Assistant Borough Education Officer: A. C. Cleveland. Education Welfare Officers: S. J. Mann and L. Saysell. School Health Service. Medical Officers. Whole-time. Medical Officer of Health Deputy Medical Officer of Health Assistant Medical Officers Part-time. Ophthalmic Surgeon Orthopaedic Surgeon Dental Officers. Part-time. Clinic Assistants Part-time. Health Visitors and School Part-time Officers. Physiotherapists Orthoptist Clerical Staff. Chief Clerk Dr. H. B. C. Carter-Locke Dr. A. J. 1. Kelynack Dr. P. A. Currie Dr. C. Maxwell Dr. Eric Lyle Mr. K. F. Hulbert Mr. A. F. King Mrs. C. Mckenzie Lindsay Vacant Mrs. E. Brooks Mrs. D. Harris Vacant Nurses. Miss W. G. Hemmings Miss E. Chenery Miss K. Owens Miss E. Hatch Miss M. E. Wootton Mrs. V. Greig Mrs. N. M. Taylor Mrs. V. Norman Miss H. Pakes Miss J. Langmead, b.d.o. Mr. S. F. Judd Mr. E. P. J. Wythe Mrs. D. Cox Mrs. W. J. Foot Mrs. R. C. Tye Proportion of time allocated to School Health Service 25% 50%* 70% 44% 3 sessions per week. 2 sessions per month Whole-time. Whole-time. 4 sessions per weeK. Whole-time. Whole-time. 4 sessions per week. 50% 6 sessions per week. 6 sessions per week. 6 sessions per week. 3/8 3/8 Whole-time. 3/8 Whole time. * Includes duties in connection with Independent Schools. 85 to the Chairman and Members of the Welfare Sub-Committee Mr. Chairman, Ladies and Gentlemen, In presenting my review of the School Health Service for 1955, it is my privilege to comment on a year of change, progress and great activity. Last year I had to apologise for the brevity of my letter; this year my apology will be for the opposite reason—a change which the reader may not consider an altogether unmixed blessing ! Early in the year a new Deputy Medical Officer of Health, in the person of Dr. A. J. I. Kelynack, joined the staff and very soon made his presence felt by the quality and thoroughness of his work. He quickly endeared himself to all with whom he came in contact and is now a well established member of the staff for whose valued work I am personally most grateful. A most gratifying feature of the year's work has been the splendid understanding and co-operation which has existed between the educational and school health service staffs. They have all pulled their weight in the finest possible team spirit and have made a real contribution towards helping the up and coming generation to enjoy a fuller and a better life to the best possible advantage. During the year, two additional private schools and the new senior section of another school decided to take advantage of the scheme by which they are enabled to partake of the benefits of the school health services. This is a most encouraging sign and shows an increasing awareness of the value of this service, but should further private schools from time to time apply for these facilities and taking into consideration the projected programme of new maintained schools, one can foresee a staffing problem arising, as the medical staff are already working at full pressure. In this connection, it is interesting to note that in 1938 the school roll was only 5,520, but that by the year now under consideration this had risen to 9,284 with the addition of 2,521 pupils at independent schools, of whom well over half are now under the regular supervision of the school health service. Further, comparing 1938 with 1955, the following " profit and loss " table may be of some interest: 1938 1955 Periodic Medical Inspections 1777 4515 Other Inspections 9355 1972 Children found to require treatment 321 479 Minor Ailments 2647 1317 Audiometer Examinations Nil 1999 On analysing this table, one is immediately struck by the very large increase in the number of periodic medical inspections in 1955 86 compared with 1938. This, of course, is due to the great increase in the school population and the addition of a considerable number of children attending independent schools. On the other hand, there is a large decrease in the percentage of "other inspections" and this can be ascribed to the low incidence of cases requiring treatment, whether it be minor or otherwise. During the course of the year, a pure tone audiometer was acquired and thus for the first time ever the results of the ensuing examinations are recorded in this report. Before going into any details of the results of our investigations, I must record my appreciation of the way in which the staff, both medical and clerical, have shouldered this considerable extra burden. Their keenness and enthusiasm have been a pleasure to see and redound to their credit greatly. 1 must here, however, issue a word of warning for it so happened that circumstances conspired in the form of a long term and comparatively small numbers requiring medical inspections during the Christmas term, to enable us to undertake this task, which only commenced in September, 1955, on such a large scale. It was because I could foresee that this particular term presented such a golden opportunity, which might well not be repeated for years, that I have pressed this new service to the utmost during the last quarter of the year and there seems no prospect of being able to produce figures of this magnitude again in the foreseeable future. Reverting to the figures themselves, it will be noticed that of the 1,999 who have undergone audiometric examination, 108 failed at the first attempt. If my mathematics are correct (which is an admittedly rare occurrence!) this gives a percentage failure of 5.4. On the surface this may appear a small number, but it is well to remember that a high percentage of the time devoted to this service has been given to the 108 and not to the 1,891 who were found to be normal. Of the 108 who came under further investigation, many were found to be normal when examined under more individual and favourable circumstances. Others were found to have conditions which could be relieved immediately, e.g., by the removal of foreign bodies from the ear, and yet another set were found to be suffering from catarrhal conditions necessitating more complicated forms of treatment including such operations as removal of tonsils and adenoids. In addition, one or two cases of children who were suspected of being backward when they were really deaf, have been discovered, and it has now become a routine part of the examination of all children who are being tested for a suspected disability of mind that they should be subjected to an audiometric survey. A further advantage is that all children who come under this examination are seen on an additional occasion during their school career by the doctor and, although not of course subjected to a 87 thorough overhaul, the possibility exists that any other developing defect would be noted. As this is an entirely new service, 1 have dilated upon it at fairly great length and personally feel that it has been well worth the trouble involved and that the results so far obtained, if not spectacular, will be to the future advantage of some, at least, of the children of Bromley. The year 1955 will surely go down in history as having a memorable summer with its prolonged heat and absence of rain, but as often happens on such occasions, an extensive epidemic of infantile paralysis affected the country. In Bromley, we were comparatively fortunate especially as regards the school children, for out of a total number of fourteen confirmed notifications received during the year, only six referred to children of school age. Of these cases, three were paralytic, including two of the Bulbar type, and three were non-paralytic. In the present state of our knowledge, I feel that it is proper for me to give as much publicity as possible to the fact that personal cleanliness is probably the greatest single factor in preventing the spread of this disease, and that particular emphasis should be laid on the importance of thorough washing of the hands. This is, of course, at all times very important, especially prior to the preparation of food, but in my opinion is doubly so when we are in the midst of an epidemic of a disease which so naturally gives rise to so much public alarm. Hand washing is a simple operation which can be so easily forgotten, but what tragedies that forgetfulness can beget. I have dealt at some length with a few of the activities of the school health service, but there are many other valuable routine services proceeding daily, notes on which will be found in the body of this report. Taking the year as a whole, I feel justified in regarding it as one of expansion and progress, and I am glad to be able to thank each and every member of the staff for his or her contribution to this successful outcome. In conclusion, I should like to thank the Borough Education Officer for a year of happy collaboration, and the members of the Welfare Committee for their continued encouragement and interest in what I think is generally agreed to be a very rewarding task. H. B. C. CARTER-LOCKE. Medical Officer of Health. 88 SCHOOLS, FURTHER EDUCATION AND CLINICS Numbers on School Roll. 1953. 1954. 1955. County Primary Schools 5,073 5,162 5,196 County Secondary Schools 1,987 2,044 2,196 County Grammar and Technical Schools 1,837 1,833 1,892 Independent Schools 2,216 2,265 2,521 11,113 11,304 11,805 Further Education. Bromley College of Arts. Tweedy Road. Department of Building. Wharton Road. Technical Institute. Bromley Technical Institute, "Springhill," College Road. Clinics. Minor Ailments. North Clinic, Station Road Monday to Friday a.m. (Doctor in attendance) Thursday a.m. South Clinic, Princes Plain Monday to Friday a.m. (Doctor in attendance) Wednesday a.m. Medical Room, Hayes School Monday to Friday a.m. (Doctor in attendance) Wednesday a.m. Medical Room, Burnt Ash School Monday to Thursday a.m. (Doctor in attendance) Thursday a.m. Medical Room, Southborough School Monday, Wednesday and Friday a.m. Medical Room, Aylesbury Road School Monday. Wednesday and Friday a.m. Dental. North Clinic, Station Road South Clinic, Princes Plain Monday to Friday a.m. & p.m. Saturday (By appointment only.) Specialist Clinics. Ophthalmic. North Clinic, Station Road Monday & Wednesday a.m. Friday P.m. (By appointment only.) Orthoptic. North Clinic, Station Road Monday p.m. Tuesday a.m. & p.m. Thursday a.m. & p.m. Friday a.m. (By appointment only.) Orthopadic. North Clinic, Station Road 1st & 3rd Friday in every month p.m. (By appointment only.) Physiotherapy. North Clinic, Station Road Tuesday a.m. & p.m. Thursday and Friday a.m. (By appointment only.) Speech. South Clinic, Princes Plain Wednesday p.m. (By appointment only.) Lip Reading. South Clinic, Princes Plain Wednesday 5-6 p.m. Saturday 10 a.m. - 12 noon (By appointment only.) PERIODIC MEDICAL INSPECTIONS. A total of 3,830 children were examined at the periodic medical inspections, necessitating the holding of 269 medical inspection sessions. The average attendance at each session was 14.2. (Figures for 1954 were 3,998 examinations, 318 sessions, and average attendance at each session 12.6.) 345 individual pupils were found to require treatment, excluding dental diseases and infestation with vermin. This gives a percentage of 9.0 compared with 7.2 for 1954. Detailed information on the general condition of the pupils inspected will be found in Table IIB in the appendix to this report. Comparative rates of the general condition of the pupils examined during the past five years are as under: 1955 1954 1953 1952 1951 Category "A" (Good) 31.54% 33.74% 32.11% 50.08% 64.42% Category "B" (Fair) 65.12% 64.91% 66.28% 48.90% 34.63% Category "C" (Poor) 3.34% 1.35% 1.61 % 1.02% 0.95% It will be noted that the figures for the general condition of pupils have shown little significant alteration during the past three years, and it can be considered that all in categories "A" and "B" are satisfactory. 50 MINOR AILMENTS. A total of 2,370 attendances were made at the various clinics for the treatment of minor ailments. Details of the main type of ailment treated are given below: 1951 1952 1953 1954 1955 Ringworm, Body 25 6 5 7 10 Scabies — — 3 2 — Impetigo 26 8 21 8 29 Other Skin Diseases 457 372 276 271 185 Minor Eye Defects 463 493 455 649 404 Minor Ear Defects 240 197 105 51 33 Miscellaneous (e.g., minor injuries, bruises, sores, chilblains, etc.) 2,277 1,973 1,268 1,079 656 Treatments are carried out by the School Nurses, and any cases attending minor ailment clinics and requiring medical advice are referred to the General Practitioner or to the clinic doctors at their visits. The numbers of cases treated and total attendances at the clinics show a decrease when compared with the figures for the previous year. This continues a trend which has been apparent for some time, the reasons for which have been the subject of comment in previous reports. SCHOOL HYGIENE AND NEW SCHOOLS. The only improvement worthy of note which was carried out during 1955, was the provision of additional sanitary offices at the Grammar School for Girls. This was necessary in view of the pressure on the accommodation at the school. It may also be mentioned that at the same school, the towel laundry was brought into full use for a trial period from the beginning of the autumn term, 1955. This is only an experiment for the purpose of providing data which may lead ultimately to the provision of towel laundries at all new secondary schools, and is encouraging a much greater use of the showers. Provision of New School Buildings. Primary Education. The Pickhurst Junior School is now in course of erection, and will provide maximum accommodation for 480 pupils. A large number of these pupils is already accommodated in the existing Infants' School building on the same site. When the new building is completed, the Managers and the Committee for Education may be able to extend the present restricted "catchment area" for the School so as to allow the 91 admission of pupils from the Beckenham area adjacent to the School site. The actual demand for places from this area is not known, but it is expected that the maximum accommodation will be fully taken up for the next four or five years, in consequence of the bulge in the post-war birth rate, but thereafter the numbers may gradually decline. There are no other Primary School developments contemplated at present, as the emphasis is now on the provision of new Secondary School accommodation. Secondary Education. Hayes Mixed Secondary School. Plans have been prepared for this school to be erected on land adjoining the "Gadsden" premises. Accommodation will be provided for 600 boys and girls of 11 plus who will take a course extending eventually for five years. The pupils will include admissions from the Biggin Hill and Cudham area, who at present attend Burnt Ash Secondary School for Girls and Quernmore Secondary School for Boys. It is expected that the first instalment of the new building will be ready for occupation at the beginning of the educational year 1958-9, when girls will be admitted. In the meantime, as from September, 1956, the nucleus of the boys' side will be accommodated in the " Gadsden " premises. Technical School for Boys. Work is now proceeding on the erection of this School on the Oakley Playing Field site. Accommodation will be provided for 660 boys of 11 plus who will take a course extending for at least five years. The boys will be drawn from the Beckenham and Bromley area. At present Bromley boys attend the Technical Schools in the Beckenham and Chislehurst Divisions, but when the new School is ready, all transfers to Technical Schools from Bromley and from Beckenham will be made to the new Bromley School. It is not expected that the School will be ready for occupation until the educational year 1957-58. Technical School for Girls. Plans have been prepared for the extension of the existing School buildings to provide a total accommodation of 600 places. The existing buildings accommodate 425 girls. The School will continue to accommodate girls from the Beckenham and Bromley areas and the increased numbers will come 92 from the alteration of the promotion age from 13 to 11 years. It is not expected that the additional accommodation will be available until late in the educational year 1957-58 or early in 1958-59. Further Education. The Kent Education Committee are now considering plans for the first instalment of the Regional College of Technology to be erected on the Rookery site. Bromley Common. It is proposed to begin with the erection of the first instalment in the course of the financial year 1956-57. This does not affect, at this stage, the existing College of Art. Details of the number of pupils to be accommodated in the first instalment are not yet available. SPECIAL EXAMINATIONS. In addition to the periodic medical inspections, a further 1.492 cases came under medical supervision during 1955, involving 1,944 medical examinations. (Figures for 1954 were 1,414 cases and 1,932 examinations.) 54 cases requiring special investigation were examined at the Municipal Offices, and of these 31 had their intelligence quotients investigated—a task of no small magnitude in itself. 141 cases were referred to the various hospitals for specialists' advice and treatment, of which 86 were ear, nose and throat cases. AUDIOMETRY. A programme of hearing tests, using the pure tone audiometer, was inaugurated during the autumn term, and has now become an established feature of the School Health Service in Bromley. This scheme aims to ensure the recognition of children with defects of hearing, which, though often not amounting to obvious deafness, can, if unnoticed, substantially handicap the child during his or her school career. There are two main aspects to the work, namely, preliminary "screening" tests at the schools for the discovery of children with hearing defects and the subsequent individual examination and treatment of these children, to which a considerable proportion of the time available is devoted. With the type of audiometer used, the initial screening test, although simple enough to enable a child to co-operate fully, will detect any significant impairment of hearing over the range of tones used in normal speech. The test can be carried out rapidly and although each child is examined individually, and each ear is tested separately, substantial numbers, such as a complete class can be examined at a single session. 93 By the end of the year a total of 1,999 children had been examined. Of these, 754 were between 9 and 11 years of age; a larger group, 1,226 were between 7 and 9 years old, and the small remaining number were slightly younger children. Although the programme this year was devoted largely to the examination of pupils attending the Junior Schools in the Borough, it is intended, as time and circumstances permit, to extend the service to the other age groups. Of the children examined, 108 failed the initial test, but approximately 40% of these have subsequently proved to have normal hearing when re-examined under more favourable conditions. Of the others, many are still under investigation so that the figures available are necessarily incomplete and it is not possible, for example, to say what proportion of the defects will prove to be remediable. In the great majority of cases so far discovered, the deafness has been due to catarrhal conditions affecting the middle ear. The cause next in order of frequency being recurrent acute otitis media. A smaller number of defects were found to be due to wax or foreign bodies in the meatus. So far, fifteen cases have been referred to consultants for opinion, and a further three to their family doctor for treatment. Of those referred to consultants, eight were recommended for operative or other treatment, and the remainder for further observation by the specialist concerned. Another group of cases, where the defect is slight and probably of a temporary nature, is remaining under observation by the school doctors, in some cases with treatment at the school clinics. Those with wax or foreign bodies in the ear have been treated, often with dramatic results. With only incomplete figures available, it is perhaps too soon for the merits of the scheme to be fully assessed. It has become clear that a number of children with hearing defects can be cured or greatly helped by suitable treatment and, at least, further damage to the ear will have been prevented. In other cases, where the ear has been seriously damaged by previous disease and treatment proves disappointing, measures such as the use of hearing aids, attendance at lip reading classes, and education at Special Schools, mav be necessary. In every case, however, awareness of the child's difficulty will enable appropriate steps to be taken to meet his particular needs, and even where this is nothing more spectacular than suitable placing in the classroom, a valuable service will have been performed. INDEPENDENT SCHOOLS. During the year, medical inspections were carried out at nine independent schools, two of which were taking advantage of this scheme for the first time. In all, at the 65 sessions held, 685 pupils 94 in various age groups were examined; statistical details of these examinations will be found in Table VIII at the end of this report. The full measure of support which parents have continued to give to this voluntary scheme has been a gratifying feature, worthy of special comment at a time when the present system of periodic medical inspections is the subject of so much discussion. The fact that approximately 90% of parents accepted this facility where it was available indicates that parental opinion, at least, is very much in favour of this service. Their support, in turn, adds to the value of the examination, particularly when treatment is recommended. OTHER EXAMINATIONS. In addition to the examination of school children, the Medical Officers examined 30 students and 10 teachers. 30 other employees of the Committee were also examined for superannuation purposes, etc. DENTAL SERVICE. A year of satisfactory work can be recorded, for even without the assistance of a part-time dental surgeon at the North Clinic, the total number of children inspected has risen from 4,704 in 1954, to 7,427 in 1955. In addition, during the same period, the number treated has risen from 2,140 to 2,632. A glance at Table IV in the appendix will indicate the volume of work undertaken by the dental officers, who are both worthy of the highest praise for their enthusiasm and keenness in this highly important task. Great concern is still felt, both locally and at national level, at the lack of sufficient numbers of recruits entering the dental profession, and until such time as this shortage of dental surgeons can be overcome, a great burden is placed on the shoulders of those at present practising dentistry. If the position cannot be remedied, the time will come when the obtaining of necessary treatment will become progressively more difficult with dire results to the dental health of the population. Mr. King reports on the North Clinic: "During 1955 more time has been devoted to the inspection of periodic age groups at school, the result being that over 750 more children were examined than last year. The number of children referred by the Assistant Medical Officers and accident cases and emergency treatments have also greatly increased. It has not been possible to replace the part-time Dental Surgeon who resigned in November, 1954, and the lack of adequate 95 fessional personnel necessarily affects the amount of work which can be undertaken at the Clinic. Orthodontic treatment is still in great demand, and thanks to the willing co-operation of both parents and children valuable assistance has been rendered in this very rewarding branch of dentistry. My thanks are due to Mr. N. K. Thorne. the County Orthodontist for his valuable assistance. All Maternity and Child Welfare patients presenting themselves for treatment have been restored to dental fitness. I also take this opportunity to express my gratitude to the staff of the Radiological Department at Bromley Hospital for the assistance they have rendered during the past year." Mrs. Lindsay reports on the South Clinic:— "I have pleasure in reporting a considerable improvement in the dental condition of the children's mouths in this area. As a consequence it has enabled me to undertake more frequent inspections than in past years. The number of new orthodontic cases is on the increase and with the ready co-operation of parents and children, some very satisfactory results have been achieved. Conservative and other treatment has been maintained at a fairly high level—over 3.000 permanent and temporary teeth have been filled in the past year—and there has been approximately 650 maternity and child welfare attendances for treatment. It is hoped, in view of the improved progress reported above, that in the near future time will be available for more specialised work, i.e., crowns and inlays." OPHTHALMIC CLINIC. The position with regard to new cases is most satisfactory, but there is still considerable delay in the call up of cases for reinspection. In an endeavour to reduce the arrears at this clinic, provision has been made in next year's estimates for an additional session to be held each week. Dr. Lyle has continued his very valuable work throughout the year, both for the children of Bromley and also for a considerable number of out district children, and Table III (Group II) in the Appendix, bears testimony to the extent of his efforts. Dr. Eric Lyle reports :— "The work of the eye clinic has been carried out steadily during the past year. There are no alterations of any kind to report. The total number of new cases examined was 317, and the total number of attendances by old patients for continued supervision and treatment was 1,234. thus making a grand total of 1,551. New cases are able to be dealt with almost as soon as they are referred from the School Medical Examinations. 96 I should like to thank the Health Visitors for their consistent co-operation and help in all matters relating to the Eye Clinic. My thanks are also due to the Clerical Staff for the smooth running of the present appointment system, and for dealing with the many enquiries and requests." ORTHOPTICS. Attendances of patients have been good on the whole, although there are still a number of children who live too far away to attend frequently for treatment. Unfortunately the clinic had to be closed for two months during the summer owing to a change of Orthoptist. but many of the parents co-operated by continuing with exercises at home where applicable. Few children have been discharged during the last four months of the year, but there are several satistactory cases in which the child is being kept under observation until older. This prevents a recurrence of symptoms in later years, which sometimes occurs if a patient is completely discharged when very young. Full details of the work of this clinic will be found in the Appendix to this report. EAR, NOSE AND THROAT DEFECTS. One hundred and twenty-two children received operative treatment in hospitals for adenoids and chronic tonsillitis. This number shows a considerable decrease over that for tne previous year, and is undoubtedly due to the fact that tonsil and adenoid operations were held in abeyance for some time during the summer months owing to the prevalence of poliomyelitis. One child received operative treatment for mastoid, and one for sinus trouble. In addition to the above, forty-eight children received other forms of treatment at the school clinics and as out-patients at the hospitals. ORTHOPAEDIC CLINIC. This service has continued to function well throughout the year under the able control of Mr. Hulbert. Details of the work undertaken will be found in the Appendix at the end of this report. Mr. K. F. Hulbert reports:— "The Orthopaedic Clinic has continued on the first and third Friday of the month throughout the year. During the year under review, the number of patients attending has been slightly less than in other years, but the kind of cases being sent up is still very largely the same. Towards the end of the year. Mr. Taylor, the Physiotherapist, left us after several years of very excellent service, and his place has been taken by Miss Pakes, who is being assisted by Mrs. Norman. 97 As in other years, the problem of the spastic child still occupies a lot of our attention, and all schemes for helping the education and rehabilitation of these children should be pressed as hard as possible. We have been pleased to see further evidence of co-operation and interest between our department and the physical education section of the schools, and we would like this to continue and to extend." PHYSIOTHERAPY AND SUNLIGHT. Mrs. Norman reports:—"Both these clinics have continued to be varied and interesting. Every co-operation has been obtained from the schools, both in attendance at the clinic, and in continuance of special exercises for certain postural cases by the Physical Training staff of the schools. This is much appreciated. The remedial classes have been well attended by boys and girls. The number of attendances being about the same as last year. These are mainly cases of faulty posture, which benefit by corrective exercises, especially in the case of the older age group 11-16 years. At present, there is only one spastic child on treatment, and he is also attending a special school. All the other spastic cases have settled down and are getting on well in their various special schools. Mr. Taylor left the clinic in August to take up work with spastics, under the Wilfred Pickles scheme. The Sunlight clinic has had a good year, a total of 816 treatments being given. The majority of children benefit greatly from a course of general sunlight when correctly treated. There have been a number of cases of acne treated with sunlight with good results " SPEECH CLINIC. Mrs. Swan has continued to attend at the Bromley Speech Clinic for one session per week. At the end of December her resignation was received, and it will take effect at the end of March, 1956. Steps are being taken to appoint a successor. Nine cases were closed during the year. Of these, six were closed in view of the improvement made following treatment. Of the remaining three cases, two were reported to have improved prior to appointments being offered, and one was reported to have improved when appointments were offered. Nine cases were in contact with the clinic at the end of 1955. and will continue to attend at the clinic into 1956. At the end of 1955. 107 cases were on the waiting list. 98 VERMIN AND UNCLEANLINESS. Seventeen thousand three hundred and seventy-one inspections were carried out by the School Nurses at Primary and Secondary Schools. It was not found necessary for any inspections to be made at the Grammar and Technical Schools. Six pupils were found to be infested, with a further forty showing minor evidence of infestation. These figures show a very high standard of cleanliness which is a tribute to the care that parents devote to their children, and is worthy of the highest praise. HANDICAPPED CHILDREN. During the year, 54 special cases were examined at the special clinics held at the Municipal Offices on Saturday mornings. Of this number, 20 have been certified as handicapped and not suitable for education in ordinary schools. At the present time, there are 72 known educationally sub-normal and physically handicapped children in the area. Details of these children are given below Waiting admission. In Residential Schools for E.S.N, children 4 — Attending Day Schools for E.S.N, children 19 4 In Residential Schools for Blind and Partially Sighted children 3 — In Day Schools for Blind and Partially Sighted children 2 — In Residential Schools for Deaf and Partially Deaf children - - Attending Day Schools for Deaf and Partially Deaf children 5 — 111 Ordinary Schools (Physically Handicapped children) In Residential premises for Physically Handicapped children 6 1 In Day Schools for Physically Handicapped children 9 — In Residential premises for Epileptic children — — In Residential premises for Delicate children 3 — Attending Day Schools for Delicate children - - In Residential premises for Mal-adjusted children 7 1 Receiving Home Tuition 1 — As will be seen from the foregoing table, there are now only six handicapped children awaiting admission to special schools, and of these, four are educationally sub-normal. There are 31 known ineducable children whose homes are in the area, 11 of these being in institutions, and 20 at home. SCHOOL MEALS AND MILK IN SCHOOLS. Further progress was made during the year on the provision for school meals in the Borough, and the new kitchen at St. Georg' s 99 Bickley School, equipped to serve 150 meals daily, was opened at the beginning of the Spring Term. During the summer holidays, the kitchen at Pickhurst Primary School was enlarged to enable the output to be increased from 250 to 500 meals daily to cater for the additional numbers of meals likely to be required when the erection of the Junior School is completed. As part of the new Technical School for Boys being erected in Oakley Road, a kitchen to serve 550 meals is being provided, and work on the construction started towards the end of the year. In addition, plans have been approved for a kitchen to serve 450 meals daily for the new Hayes Mixed Secondary School, on which it is hoped construction will start next year. It is of interest to note that for the first time since the School Meals Service started in the Borough in 1941, a Ministry of Education inspection of the Service was carried out in November, 1955, as part of a General Survey taking place in the North West Kent area. The report on the local survey had not been received from the Ministry by the close of the year. At the beginning of the Autumn Term the daily average number of meals being served amounted to 6,806, which showed a daily increase of approximately 430 meals over the corresponding period last year. A return to the Ministry of Education showed that on a single day in September/October 67.39% of the pupils in attendance at Primary and Secondary Schools received a mid-day meal. The school canteens are under regular supervision by the Sanitary Inspectors, and a very high standard of hygiene has been maintained throughout the year. At the end of the year, arrangements were being completed for instructional classes to be given to the canteen staffs with a view to further improving the standard of food handling. A return to the Ministry of Education showed that on a single day in September/October, 1955. 87.54% of the pupils in attendance at Primary and Secondary Schools received milk. EMPLOYMENT OF YOUNG CHILDREN. The number of children examined by the Medical Officers in respect of fitness for employment out of school hours showed a considerable increase over the number for the previous year. Two hundred and two examinations were carried out and in every instance but one. fit certificates were issued. The figures for the year 1954 were 146—all of whom were fit for employment. 100 INFECTIOUS DISEASES IN SCHOOLS. There was a large increase in the number of cases of notifiable infectious diseases in children of school age in 1955. when compared with the previous year. A total of 535 notifications being received, as against 299 for 1954. This increase was to be expected and is accounted for by the rise in the number of cases of measles. Outbreaks of this disease usually occur in alternate years, that is to to say, when a large number of non-immune children are congregated at school. In other words, in the year following an epidemic, there are normally too few susceptibles left in the schools to allow of an outbreak, as one attack of measles usually confers a life-long immunity. Four hundred and thirty-three cases of measles were notified (123 in 1954). and six of these were admitted to hospital. Thirty-eight cases of Scarlet Fever were notified as against forty-six during the previous year. The infection continued to be mild in character and only three of these cases were admitted to hospital. Notifications of Whooping Cough showed a sharp decline, 49 cases occurring as against 118 during 1954. Two of these cases were admitted to hospital. Six cases of Poliomyelitis occurred in children of school age. Three were paralytic and three non-paralytic, and all cases were isolated in hospital. There were no child deaths from this disease. In addition to the above, 3 cases of Dysentery. 4 of Pneumonia and 2 cases of Food Poisoning were notified. No case of Diphtheria occurred in the area during 1955. nor were any new cases of Tuberculosis in children of school age notified. The following table gives details of incidence and number of cases of the various diseases notified Disease Total No. of cases No. admitted to Hospital Seasonal incidence Jan. Feb . Mar . Apl. May June July Aug. Sept. Oct. Nov, , Dec. Scarlet Fever 38 3 1 4 11 3 6 5 2 1 3 1 1 Measles 433 6 47 105 82 123 20 32 20 2 1 — — 1 Whooping Cough 49 2 13 12 7 1 2 5 3 6 — — — — Poliomyelitis (Paralytic) 3 3 - - - - - - - - 1 - - 2 Poliomyelitis (Non-Paralytic) 3 3 1 2 — — — Dysentery 3 1 - - - - - - 3 - - - - - Pneumonia 4 1 — — — 2 1 — — — — — — 1 Food Poisoning 2 1 — 1 — — — — — — 1 — — — Totals 535 20 61 122 100 129 29 42 28 9 6 3 1 5 101 PHYSICAL EDUCATION, 1955. The following is the report of the Area Advisers of Physical Education :— " During recent years a period of experiment and investigation has been in progress in the Bromley area, through which it is hoped to determine the most effective type of Physical Education for building strong, healthy members of the community. It is now time to take stock to see whether our present schemes are on the right lines and whether we are achieving our aims in relation to the understanding and development of the individual child. The realisation that the child has need of many and varied outlets for development, makes it more than ever necessary for the teacher to study the education of the child as a whole, thus widening his knowledge and understanding of the scope of Physical Education. Those interested in the subject understand that a need exists to formulate provision during the full school course for a wider range of physical activities than formerly, which will be fully developmental and which may be usefully continued as recreation in adolescence and adult life. If we are to enable an individual to reach his full capacity, we must not apply standard formula or mass production methods to large groups of children with their differing backgrounds and personalities, taught under widely varying conditions. But this freedom from standardised lessons does imply greater responsibility ; it demands more detailed understanding of the individual pupil and of the fundamental principles underlying schemes of work. These fundamental principles must still remain the central guiding factor in any general scheme of Physical Education and must not be lost sight of in the widening programmes ahead. The misguided idea, current in some quarters, that discipline in schools now sanctions unbridled self expression must be discouraged. The child best develops a sense of self-discipline in a school community where both ' rights ' and ' duties' go together. Within such a community a tradition of service is fostered, and no child is allowed to drift without control or regard for others. In a good physical training lesson a sense of responsibility, service and self-discipline are an essential part of modern training. During this period of experimentation, in spite of teething troubles and natural feeling of indecision, the standard of effort at all age levels has shown marked improvement and is still progressing favourably. The physical education in schools in the Borough is generally alive, interesting and progressive, though we could still wish for greater effort in a few cases. Games once again seem to have suffered most from the vagaries of inclement weather, though the normal lessons in physical education suffered rather badly during the early months of the year. This particularly 102 applies to schools where the halls have been taken over as classrooms. thus leaving no indoor accommodation for this type of emergency which adversely affects the work of the school as a whole. The return of the halls to normal use will be welcomed and would be of great benefit to the schools. Gymnastics The freedom of the teacher to plan his lesson away from set patterns and published syllabuses or schemes of work has produced some interesting and stimulating results in gymnastics in Secondary Schools. In Girls' Secondary Schools, the tremendous growth of interest in educational dance has again strongly influenced the type and the presentation of indoor work. Girls continue to receive opportunities and scope for experimenting and developing their own activities, and the results observed during 1955 support the view that movement training appeals to the adolescent girl, giving her a feeling of confidence and achievement as well as grace and ease of movement and a sense of poise. On the Boys' side, gymnastics have remained the primary means of physical education, but increased attention has been given to some non-gymnastic activities popular in the boys' post-school life. During the year under review, indoor work in boys' schools has developed along two distinct lines, and opportunities have been afforded to assess the relative merits of each : (1) General Schemes in which individual lessons were devoted to developmental work of a gymnastic nature, together with a number of separate skills from various sports and games. (2) Blocked Schemes in which one particular facet of physical education was allocated a number of consecutive periods, the various branches of Physical Education being given due attention throughout the academic year In Boys' Secondary Schools ' circuit training' has been introduced as a means of developing strength and of providing challenge in older boys. It is hoped that this method of training will give a new incentive to the less skilful performer, since it relates an individual's performance to his physical ability. Some experiments have been made in Secondary Schools during 1955 to allow a certain amount of choice of physical activity to older boys and girls. In doing so. recognition has been given to the wide range over which human physique can vary and to the fact that successful performance in the different fields of physical education is often closely related to physique. Where there is adequate accommodation and sufficiently qualified physical education staff, this development has proved most successful and appears worthy of closer attention in the future. 103 Outdoor Games and Sports Training in the basic skills of the major games, sports and athletics has continued as part of the normal curriculum, and facilities have on the whole been well used. More attention has been paid to increasing the number of track and field events in athletics and to choosing more than one major game during winter and summer. With the increase in the number of outdoor activities covered there remains, in some cases, much to be done to improve teaching methods and teaching techniques, if the playing field activities are to be taught with the precision which has been accorded in the past to indoor gymnastics. In some cases it is anticipated that, in the future, more time will need to be given in games lessons to training individual and team skills if the different outdoor games and sports are to be grounded effectively, and the limited time available is to be used to the best advantage. An account of the physical education scheme in Secondary Schools would be incomplete without reference to its full expression in competitions and tournaments outside school hours. To this end numerous teachers have given freely of their time and energy in organising and conducting inter-house, inter-school and interdistrict matches in a variety of activities, thus enabling a host of children in the Borough to get a weekly game at their appropriate level in the seasonal sports. Games Results As a result of enquiries from schools, the following information should prove of interest. One school in the area has an excellent annual programme providing for:— (1) 5 Hockey teams. (2) 5 Netball teams, (3) 2 Cricket teams. (4) a large Tennis Section, with the following very creditable results :— Hockey Kent Schools Team—Two girls chosen. West Kent Schools Team—Four girls chosen and one reserve. East Kent Junior Team—One girl chosen as reserve. Schools Tournament—1st XI came second in Tournament. Under 15's XI came third in Tournament. Netball Kent Schools Tournament—The under 14's VII reached the final round but were defeated in the final match. 104 Cricket Kent Schools Team—Three girls chosen for team and one as a reserve. Tennis North West Kent Tournament—Two girls won the under-15 doubles. One girl second in the singles. Two girls second in the under-18 doubles. One girl second in the under-18 singles. Kent Junior Tournament—One girl with partner won the under-15's mixed doubles. One girl with partner won the girls' doubles. Bexley Tournament—One girl won the semi-final but lost in finals. Basket Ball has established itself as a popular game in Boys' Secondary Schools, and an improving standard of play is already evident. There does, however, appear to be a need for some form of local association within the Borough, comparable to the local Football Association, which will foster this particular sport during the immediate post-school years of a boy's life. A new type of lecture-demonstration was arranged at one of the schools in the Borough to illustrate the various outdoor activities and the facilities and opportunities which are available for boys and girls when they leave school. This demonstration was well supported by parties of school leavers from most of the schools in the area, and it is hoped that permanent interest has been aroused in the more individual activities of hill walking, mobile camping, rock climbing, canoeing and sailing. Swimming It is encouraging to find an increasing awareness of the value of the teaching of swimming in schools, especially in this area where facilities are so limited. We have in use at present the Public Open Air Bath, available for half sessions only during the summer months, one privately owned Swimming Bath for nine half-day sessions cach week, and an indoor Bath which is open throughout the year with only limited periods available. At present no further facilities are available to allow an extension of the swimming programme. A comparatively cheap and practical method of increasing facilities could be the introduction of small, shallow school baths, approximately 50 ft. x 15 ft.. costing between £250 and £300 to build, which could be included for schools in areas where facilities are at present meagre or non-existent. In most cases provision has been made for whole classes of pupils to attend the Baths as units, and it is understood that no child should be excluded unless medically unfit. 105 Programme SECONDARY SCHOOLS Summer Term—53 classes. Approximately 1,590 children per week. *Autumn Term—19 classes. Approximately 570 children per week. *Winter Term— 4 classes. Approximately 120 children per week. PRIMARY SCHOOLS *Summer Term—37 classes. Approximately 1,110 children per week. *Autumn Term— 2 classes. Approximately 60 children per week. * Arrangements for these terms are limited by the financial provisions approved. Achievement Tests The following achievement tests have been gained by the schools during the past year, and 513 children have been taught to swim for the first time. Distances— 20 yards — 338 pupils. 50 yards — 222 pupils. 100 yards — 73 pupils. 200 yards — 61 pupils. 440 yards — 156 pupils. E.S.S.A. Efficiency Test — 14 pupils. Once older pupils have become confident and competent swimmers, it is now thought that, whenever possible, they should be instructed in the elements of Life Saving and Diving in preference to further stroke efficiency, thus making them more valuable members of the community. Competitive Swimming Competitive swimming has its place in the swimming programme, and this is chiefly catered for by :— (a) Inter-house competitions. (b) Inter-school competitions. (c) County Galas. (d) The English Schools Swimming Association Gala. These are mostly organised and conducted by teachers' associations outside school hours, and as an outcome of these activities two Boys' Schools gained very creditable results. Older pupils seem to need an incentive to further effort, and competitive swimming appears to meet this demand. In addition it provides a great stimulus and is a means of assessing the relative efforts of individual schools of equal standing and opportunity. 106 Individual School Galas Most schools arranged small Galas as House Competitions during the summer months, and a challenge to neighbouring schools was often issued for one or two specific events. Bromley Schools Gala. A most successful Gala was held on July 2nd, 1955, at Downham Baths. It is encouraging to note that eight Primary Schools and seven Secondary Schools took an active part in the programme. The number of schools included each year is steadily increasing, and the possibility of having two Galas—one for Primary Schools and one for Secondary Schoolsmight be a matter for future consideration. Kent County Schools Gala was held in the neighbouring borough of Beckenham during the Summer term. In the final results. Bromley Schools Association gained second place, providing great encouragement and no little enthusiasm for the greater challenge of the National Championships to be held later in the year. Places gained at the Kent County Schools Gala were :— First place — 5 girls. Second place — 2 boys. 4 girls. Third place — 1 boy. 1 girl. All England Schools Gala. The choice of venue for the All England Schools Gala was allocated this year to Division II (Kent and Surrey). Downham Swimming Bath was selected for the main swimming events, as it was not possible to find other suitable accommodation within the County. The Lewisham Borough Council acted as hosts, but the main organisation of these Championships was in the hands of staffs of local schools. Special mention should be made of those Bromley residents who provided billets and hospitality to hundreds of competitors and their team managers from Thursday to Sunday during the Championships. In addition a generous tribute should be paid to the numerous teachers and members of administrative staffs who gave so freely of their time and energy to ease the flow at transit points, reception and rest centres, and canteens used for the service of meals. Included in the representatives from Area II (Kent and Surrey). Bromley Schools Association was fortunate to have five competitors—4 girls and 1 boy and 1 reserve. Only one of these competitors gained a final placing, and to her we offer congratulations. 107 Further Training of Teachers Opportunities to attend the following training and refresher courses have been made available to teachers throughout the year. Most of these classes were well attended. (1) Physical Education for teachers in Infant Schools. (2) Physical Education for men and women teachers in Junior Schools (2 courses). (3) Simple National Dances for men and women teachers (2 courses). (4) Gymnastics for men teachers in Secondary Schools. (5) Athletics for women teachers in Secondary Schools. (6) Campcraft for men and women teachers in Secondary Schools. (7) Tennis for men and women teachers in Secondary Schools. (.8) Remedial Course for men and women teachers. (9) Movement Training for women teachers in Primary Schools. Youth Activities and Adult Classes The programme of activities connected with Youth Service has. of necessity, followed the pattern of previous years. The demand from local teams for facilities for football, cricket, netball and tennis has been consistent. Alternatively, smaller groups and individuals have maintained their interest in clubs catering for walking, cycling, camping and youth hostelling. Owing to limited financial provision only two Keep Fit classes for adults, one for men and the other for women, have been possible throughout the year. Conclusion If wisely used, the excellent equipment and facilities so consistently supplied by the Committee provide a wide range of opportunity for the future ; regular use together with sound training, should produce a valuable contribution to the development in the growing generation of a well balanced physique accompanied by strength of character. The introduction of Television was generally thought to be disadvantageous to practical activities and conducive to an age of physical comfort and inactivity. Instead, however, it seems as though the development of sports programmes, competitions of varying physical activities and good technical training series, have provided additional interest in techniques and generally stimulated effort in the right direction. 108 Once again many visitors connected with Physical Education under other local authorities, in training colleges and from overseas. have visited the schools during the year. In conclusion, we wish to express our thanks to the Borough Education Officer and his staff for their valuable support, as well as our appreciation of the good work done by the Head and Assistant Teachers in the schools." F. M. BENTLEY. J. M. PELL, Area Advisers of Physical Education. 109 SCHOOL HEALTH SERVICE. STATISTICAL TABLES, 1955. TABLE I.—Medical Inspection of Pupils Attending Maintained Primary and Secondary Schools. A. Periodic Medical Inspections. B. Other Inspections. C. Pupils Found to Require Treatment. TABLE II.—A. Return of Defects Found by Medical Inspection in the Year 1955. B. Classification of the General Condition of Pupils Inspected During the Year, in Age Groups. TABLE III.—Group I. Diseases of the Skin. Group II. Eye Diseases. Defective Vision and Squint. Group III. Diseases and Defects of Ear, Nose and Throat. Group IV. Orthopaedic and Postural Defects. Group V. Minor Ailments. TABLE IV.—Dental Inspection. Treatment and Orthodontics. TABLE V.—Infestation with Vermin. TABLE VI.—Orthoptic Clinic. TABLE VII.—Handicapped Pupils. TABLE VIII.—Independent Schools. Child Guidance. Juvenile Delinquency. Boot Club. Provision of Clothing. 110 TABLE I. Medical Inspection of Pupils Attending Maintained Primary and Secondary Schools. A. Periodic Medical Inspections. Number of Inspections in the Prescribed Groups: — Entrants 652 Second Age Group 1,887 Third Age Group 407 Total 2,946 Number of other Periodic Inspections* 884* Grand Total 3,830 * Children aged 8 years. Children in their 13th year, at County Grammar and Technical Schools. B. Other Inspections. Number of Special Inspections 1,492 Number of Re-inspections 452 Total 1,944 C. Pupils Found to Require Treatment. Number of Individual Pupils found at Periodic Medical Inspections to require treatment (excluding Dental Diseases and Infestation with Vermin). Group For defective vision (excluding squint) For any of the other conditions recorded in Table II.A. Total individual pupils Entrants 25 79 104 Second Age Group 49 90 139 Third Age Group 5 24 29 Total (prescribed groups) 79 193 272 Other Periodic Inspections 43 30 73 Grand Total 122 223 345 111 TABLE 11. A. Return of Defects Found by Medical Inspection. Defect Code No. Defect or Disease Periodic Inspections. No. of Defects. Special Inspections. No. of Defects. Requiring treatment Requiring to be kept under observation but not requiring treatment Requiring treatment Requiring to be kept under observation but not requiring treatment (1) (2) (3) (4) (5) 4 Skin 12 6 67 4 5 Eyes—-(a) Vision 122 208 81 47 (b) Squint 8 5 3 — (c) Other 15 9 45 7 6 Ears— (a) Hearing 2 10 6 4 (b) Otitis Media 2 2 3 2 (c) Other 1 7 16 4 7 Nose or Throat 32 50 60 22 8 Speech 12 13 5 8 9 Cervical Glands — — 2 — 10 Heart and Circulation 5 7 2 2 11 Lungs 12 12 17 12 12 Developmental— (a) Hernia 3 — — 1 (b) Other 20 119 30 72 13 Orthopaedic— (a) Posture 36 123 26 21 (b) Flat Foot 9 53 20 22 (c) Other 33 22 57 24 14 Nervous System— (a) Epilepsy 1 1 2 — (b) Other — 7 6 10 15 Psychological— (a) Development 1 7 2 11 (b) Stability 1 9 4 4 16 Other 35 91 128 55 Totals 362 761 582 332 B. Classification of the General Condition of Pupils Inspected During the Year in the Age Groups. Age Groups (1) Number of Pupils Inspected (2) A—Good B—Fair C—Poor No. (3) % of Col. 2 (4) No. (5) %of Col. 2 (6) No. (7) %of Col. 2 (8) Entrants 652 149 22.85 438 67.18 65 9.97 Second Age Group 1,887 562 29.78 1,291 68.42 34 1.80 Third Age Group 407 154 37.84 249 61.18 4 0.98 Other periodic inspections 884 343 38.80 516 58.37 25 2.83 Total 3,830 1,208 31.54 2,494 65.12 128 3.34 112 TABLE III. TREATMENT TABLES. Group I.—Diseases of the Skin. Number of cases treated or under treatment during the year:-- By the Authority. Otherwise. Ringworm—(i) Scalp — — (ii) Body 10 — Scabies - — Impetigo 29 — Other Skin Diseases 185 — Total 224 — Group II.—Eye Diseases, Defective Vision and Squint. Number of cases dealt with: By the Authority. Otherwise. External and other excluding errors of refraction and squint 426 No information available. Errors of refraction (including squint) 1,382 Total 1,808 — Number of pupils for whom spectacles were: (a) Prescribed 778 No information available. (b) Obtained 703* * Including spectacles prescribed in 1954 and obtained in 1955. Group III.—Diseases and Defects of Ear, Nose and Throat. Number of cases treated: Received operative treatment: By the Authority. Otherwise. (a) for diseases of the ear — 1 (b) for adenoids and chronic tonsillitis 122 (c) for other nose and throat conditions - 1 Received other forms of treatment 33 15 Total 33 139 Group IV.—Orthopædic and Postural Defects. (a) Number treated as in-patients in hospitals 12 By the Authority. Otherwise. (b) Number treated otherwise, e.g., in clinics or out-patient departments 117 (new cases) 330 (re-inspections) No information available. Group V.—Minor Ailments. Number of cases treated: Miscellaneous minor ailments By the Authority. 656 Otherwise. No information available. 113 TABLE IV. Dental Inspection, Treatment and Orthodontics. (1) Number of pupils inspected by the Authority's Dental Officers: — (a) Periodic age groups 4,632 (b) Specials 2,795 Total (1) 7,427 (2) Number found to require treatment 5,887 (3) Number referred for treatment 4,758 (4) Number actually treated 2,632* (5) Attendances made by pupils for treatment 8,414* (6) Half-days devoted to: Inspection 28 Treatment 938 Total (6) 966 (7) Fillings: Permanent Teeth 3,357 Temporary Teeth 1,258 Total (7) 4,615 (8) Number of teeth filled: Permanent Teeth 3,335 Temporary Teeth 1,238 Total (8) 4,573 (9) Extractions: Permanent Teeth 698 Temporary Teeth 2,867 Total (9) 3,565 (10) Administration of general anaesthetics for extraction 1,608 (11) Other operations: Permanent Teeth 2,236 Temporary Teeth 1,357 Total (11) 3,593* * These figures include orthodontic work. Orthodontics. Number of children referred for Orthodontics 208 Number of Orthodontic appliances ordered 175 Number of Orthodontic appliances fitted 138 Attendances for Orthodontic treatment 1,564 Scaling and Polishing 348 X-Rays 120 114 TABLE V. Infestation with Vermin. Primary and Secondary Schools. (i) Total number of examinations in the schools by the school nurses or other authorised persons 17,371 (ii) Total number of pupils on roll of schools visited 7,394 (iii) Total number of individual pupils found to be infested 6* * In addition, 40 pupils showed minor evidence of infestation. (iv) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) Nil. (v) Number of individual pupils in respect of whom cleansing orders were issued (Section 54 (3), Education Act, 1944) Nil. Grammar and Technical Schools. No examinations were found necessary at these schools. TABLE VI. Orthoptic Clinic. Total number of treatments given 671 Number of new cases 63 Number of cases on occlusion alone 34 Number of cases found unsuitable 12 Number of cases postponed 431 Number of cases failed to attend 71 Number of cases put down for operation 26 Number of cures—with operation 36 without operation 23 Number of sessions, 1955 219 Number of attendances 1,253 Number of patients discharged (various reasons) 116 TABLE VII. Year 1955. Handicapped Pupils Requiring Education at Special Schools (other than Hospital Schools) or Boarding in Boarding Homes. 1. Blind 2. Partially Sighted 3. Deaf 4. Partially Deaf 5. Delicate 6. Physically Handicapped 7. Educationally Sub-normal 8. Maladjusted 9. Epileptic T 0 T A L 1-9 In the calendar year ended 31st Dec., 1955: A. Handicapped Pupils newly placed in Special Schools or Boarding Homes (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) - - - - 4 - - - - - B. Handicapped Pupils newly ascertained as requiring education at Special Schools or Boarding in Homes - 3 - - - 2 4 3 - - 115 1. Blind 2. Partially Sighted 3. Deaf 4. Partially Deaf 5. Delicate 6. Physically Handicapped 7. Educationally Sub-normal 8. Maladjusted 9. Epileptic T O T A L 1—9 On or about December 1st, 1955: (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) C. Number of Handicapped Pupils from the area: (i) Attending Special Schools as: (a) Day Pupils - 2 3 - - 9 19 1 - - (b) Boarding Pupils 2 1 1 — 4 5 4 6 — — (ii) Attending Independent Schools under arrangements made by the Authority - - 1 - - - - - - - (iii) Boarded in Homes and not already included under (i) or (ii) - - - - - - - - - - Total 2 3 5 — 4 14 23 7 — — D. Number of Handicapped Pupils being educated under arrangements made under Section 56 of the Education Act, 1944: (i) in hospitals - - - - - 1 - - - - (ii) elsewhere - - - - - - - - - - (iii) at home - - - - - - - - - - E. Number of Handicapped Pupils from the area requiring places in Special Schools (incl. any such unplaced children who are temporarily receiving home tuition) - - - - - 1 - - - - Amount spent on arrangements under SECTION 56 of the Education Act, 1944, for the education of handicapped pupils otherwise than at school, in the financial year ended 31st March, 1955 ... £5, 7s. 6d. Number of children reported during the year: — (a) under Section 57 (3) (excluding any returned under (b) ) 6 (b) under Section 57 (3) relying on Section 57 (4) Nil. (c) under Section 57 (5) 1 of the Education Act, 1944. 116 TABLE VIII. Independent Schools. Number of schools visited 8 Number of Medical Inspection Sessions 65 Number of children examined (various age groups) 685 Number of Re-inspections 28 Nutrition Table. Classification " A " (Good) 281 pupils or 41.02% „ " B " (Fair) 402 pupils or 58.68% " C " (Poor) 2 pupils or 0.29% Table of Defects found by Medical Inspection. Defect or Disease. Number of Defects: — Requiring treatment. Requiring observation Skin 6 6 Eyes, Vision 29 46 Eyes, Squint 2 2 Eyes, Other — — Ears, Hearing 3 2 Ears, Other 4 — Nose and Throat 8 10 Speech 1 — Cervical Glands 1 2 Heart and Circulation — 1 Lungs 7 7 Developmental, Hernia — 2 Developmental, Other 5 5 Orthopedic, Posture 18 2 Flat Feet 44 4 Other 7 7 Nervous System, Epilepsy 1 — Psychological Development — 1 Stability 1 2 Other 4 3 Total 141 102 117 CHILD GUIDANCE. Six cases were referred for examination and treatment at the Psychiatric Departments of various hospitals. JUVENILE DELINQUENCY. During the year 66 children and young persons appeared before the Local Court. The types of offences were :— Larceny and attempted larceny 46 Wilful damage 1 Breaking and entering 4 Road Traffic Act 12 Receiving 1 Insulting words and behaviour 1 Assault 2 Indecent exposure 1 Riding cycle to the common danger 5 Riding cycle on footpath 5 Riding cycle with no brakes 1 Riding cycle with no lights 2 Setting off fireworks in thoroughfare 1 Being a passenger on a Public Service vehicle failed to declare journey 1 Breach of probation 2 BOOT CLUB. The outstanding feature of the Boot Club during 1955 was the reduction of the rate of bonus to 2½% on the 14th September. There were 327 members on the 31st December, and trading during the year may be summarised as follows :— Deposits from members £369 Number of vouchers issued 335 Value of vouchers issued £375 WELFARE—PROVISION OF CLOTHING. Fourteen applications were received during the year, as a result of which fifteen children were provided with clothing at a total cost of £149 3s. 7d.